1 00:01:33,570 --> 00:00:44,470 [Music] 2 00:01:53,000 --> 00:01:33,580 so 3 00:01:53,010 --> 00:02:05,030 [Music] 4 00:02:10,070 --> 00:02:07,670 greetings and salutations friends and 5 00:02:11,510 --> 00:02:10,080 welcome back to truth seekers today i'm 6 00:02:14,790 --> 00:02:11,520 very excited to announce that we're 7 00:02:16,390 --> 00:02:14,800 beginning a new series on the opioid 8 00:02:18,390 --> 00:02:16,400 epidemic 9 00:02:20,390 --> 00:02:18,400 i've been wanting to cover this topic 10 00:02:23,110 --> 00:02:20,400 for quite some time because i know many 11 00:02:25,510 --> 00:02:23,120 people who have been affected by it 12 00:02:27,190 --> 00:02:25,520 having grown up in a place 13 00:02:30,710 --> 00:02:27,200 uh where 14 00:02:33,430 --> 00:02:30,720 heroin was literally everywhere 15 00:02:36,869 --> 00:02:33,440 but i needed somebody to help me do this 16 00:02:38,630 --> 00:02:36,879 i need to find a someone who has really 17 00:02:41,030 --> 00:02:38,640 dug deep into this 18 00:02:43,030 --> 00:02:41,040 to help me navigate 19 00:02:46,949 --> 00:02:43,040 what quite possibly i thought was a 20 00:02:50,470 --> 00:02:48,869 i'm pleased to say that i found just 21 00:02:52,630 --> 00:02:50,480 such a person 22 00:02:54,630 --> 00:02:52,640 and he will be our guest tonight art 23 00:02:56,869 --> 00:02:54,640 levine is an author and investigative 24 00:02:58,869 --> 00:02:56,879 journalist journalist whose work has 25 00:03:01,030 --> 00:02:58,879 been featured in major news outlets 26 00:03:02,830 --> 00:03:01,040 across the united states 27 00:03:05,509 --> 00:03:02,840 he is the author of mental health 28 00:03:07,910 --> 00:03:05,519 incorporated how corruption lacks 29 00:03:10,229 --> 00:03:07,920 oversight and failed reforms endanger 30 00:03:12,149 --> 00:03:10,239 our most vulnerable citizens 31 00:03:14,869 --> 00:03:12,159 which is available on amazon and the 32 00:03:15,990 --> 00:03:14,879 link is in the description of this video 33 00:03:18,229 --> 00:03:16,000 below 34 00:03:19,350 --> 00:03:18,239 recently he has turned his talents and 35 00:03:21,830 --> 00:03:19,360 attentions 36 00:03:24,149 --> 00:03:21,840 towards investigating the opioid 37 00:03:26,550 --> 00:03:24,159 epidemic in the united states his 38 00:03:29,190 --> 00:03:26,560 shocking revelations and conclusions 39 00:03:32,390 --> 00:03:29,200 cast new light into a dark story about 40 00:03:34,550 --> 00:03:32,400 money power influence and corruption 41 00:03:37,030 --> 00:03:34,560 his shocking conclusions are not only 42 00:03:40,470 --> 00:03:37,040 cause for concern but also a call to 43 00:03:43,110 --> 00:03:40,480 action and a major wake-up call 44 00:03:45,270 --> 00:03:43,120 his conclusions cast a bright new 45 00:03:47,350 --> 00:03:45,280 spotlight on the failings of our drug 46 00:03:49,350 --> 00:03:47,360 laws policies and regulations 47 00:03:51,670 --> 00:03:49,360 surrounding the drug and rehab 48 00:03:54,309 --> 00:03:51,680 industries in the united states 49 00:03:56,550 --> 00:03:54,319 art living's work is essential in 50 00:03:57,910 --> 00:03:56,560 understanding the crisis 51 00:03:59,429 --> 00:03:57,920 and how 52 00:04:01,670 --> 00:03:59,439 we may just 53 00:04:04,550 --> 00:04:01,680 solve these major problems 54 00:04:06,869 --> 00:04:04,560 that we have so far failed so miserably 55 00:04:09,990 --> 00:04:06,879 at art levine's work on the opioid 56 00:04:13,429 --> 00:04:10,000 epidemic shows us that we have already 57 00:04:15,910 --> 00:04:13,439 lost the so-called war on drugs his work 58 00:04:17,349 --> 00:04:15,920 focuses our attention on what we should 59 00:04:19,749 --> 00:04:17,359 do next 60 00:04:21,270 --> 00:04:19,759 instead of continuing on this already 61 00:04:22,870 --> 00:04:21,280 failed mission 62 00:04:25,030 --> 00:04:22,880 he also looks at 63 00:04:27,670 --> 00:04:25,040 the collateral damage to millions of 64 00:04:30,150 --> 00:04:27,680 chronic pain patients facing draconian 65 00:04:32,870 --> 00:04:30,160 cutbacks in legitimate opioid 66 00:04:34,550 --> 00:04:32,880 prescribing leading to increases in 67 00:04:35,270 --> 00:04:34,560 suicides 68 00:04:37,030 --> 00:04:35,280 and 69 00:04:40,469 --> 00:04:37,040 street use of drugs 70 00:04:42,550 --> 00:04:40,479 while worsening their disabilities 71 00:04:44,629 --> 00:04:42,560 art living is a contributing editor of 72 00:04:46,390 --> 00:04:44,639 the washington monthly and author of the 73 00:04:48,710 --> 00:04:46,400 well-received book mental health 74 00:04:51,909 --> 00:04:48,720 incorporated so without further ado 75 00:04:54,469 --> 00:04:51,919 let's welcome him in here friends 76 00:04:56,390 --> 00:04:54,479 hi cecilia good to see you 77 00:04:58,390 --> 00:04:56,400 thank you so much for having me on this 78 00:04:59,830 --> 00:04:58,400 program this is my pleasure i've been 79 00:05:01,590 --> 00:04:59,840 wanting to do this for quite some time 80 00:05:03,510 --> 00:05:01,600 thank you for taking the time to help us 81 00:05:06,070 --> 00:05:03,520 do this and do it right with someone 82 00:05:08,310 --> 00:05:06,080 like you who can help us navigate this 83 00:05:10,870 --> 00:05:08,320 and for uh new people are new to your 84 00:05:14,390 --> 00:05:10,880 show in the past you've covered a lot of 85 00:05:15,990 --> 00:05:14,400 uh conspiracy theories and debunking uh 86 00:05:18,870 --> 00:05:16,000 uh 87 00:05:20,790 --> 00:05:18,880 in a skeptical way ufos and conspiracy 88 00:05:22,870 --> 00:05:20,800 theories and what we're facing now in 89 00:05:24,790 --> 00:05:22,880 the drug crisis might appear from the 90 00:05:27,909 --> 00:05:24,800 outside to be almost conspiracy but the 91 00:05:30,469 --> 00:05:27,919 point of it is it what we're doing now 92 00:05:32,469 --> 00:05:30,479 and government policies and in the 93 00:05:34,390 --> 00:05:32,479 private healthcare sector also have to 94 00:05:36,870 --> 00:05:34,400 be looked at skeptically so you're 95 00:05:39,270 --> 00:05:36,880 you're a good host for uh featuring that 96 00:05:41,189 --> 00:05:39,280 thank you and you know i i know about 97 00:05:43,749 --> 00:05:41,199 your book about the mental health 98 00:05:45,350 --> 00:05:43,759 industry but my first question is how 99 00:05:47,110 --> 00:05:45,360 did you pivot from the mental health 100 00:05:48,950 --> 00:05:47,120 industry into 101 00:05:50,550 --> 00:05:48,960 the opioid epidemic what got you 102 00:05:53,510 --> 00:05:50,560 interested well 103 00:05:56,230 --> 00:05:53,520 he he what happened is i i saw the 104 00:05:59,029 --> 00:05:56,240 failings first when i was covering i was 105 00:06:01,430 --> 00:05:59,039 a reporter in south florida and i 106 00:06:03,590 --> 00:06:01,440 started covering the failures of our 107 00:06:06,070 --> 00:06:03,600 mental health system and the most 108 00:06:08,390 --> 00:06:06,080 extreme examples of that were in the 109 00:06:10,309 --> 00:06:08,400 dade county jail where basically you 110 00:06:13,990 --> 00:06:10,319 have these brutal conditions that were 111 00:06:16,309 --> 00:06:14,000 like in the 18th century for people with 112 00:06:17,990 --> 00:06:16,319 untreated mental illness and i just saw 113 00:06:20,710 --> 00:06:18,000 how bad the system 114 00:06:24,550 --> 00:06:20,720 worked and at that point i 115 00:06:26,950 --> 00:06:24,560 had an early belief um that oh 116 00:06:29,110 --> 00:06:26,960 all psychiatric medications are always 117 00:06:30,790 --> 00:06:29,120 valuable for everybody which is a common 118 00:06:33,029 --> 00:06:30,800 line then later i learned that's 119 00:06:35,670 --> 00:06:33,039 actually not the case that there's a lot 120 00:06:37,510 --> 00:06:35,680 of massive over prescribing off label 121 00:06:38,390 --> 00:06:37,520 for people who didn't need it so right 122 00:06:40,550 --> 00:06:38,400 now 123 00:06:45,350 --> 00:06:40,560 so based on that 124 00:06:48,390 --> 00:06:45,360 early knowledge then i was i was in the 125 00:06:49,749 --> 00:06:48,400 early days in florida which was pill 126 00:06:54,309 --> 00:06:49,759 mill heaven 127 00:06:56,710 --> 00:06:54,319 uh in early two in so by 2000 2001 128 00:06:57,990 --> 00:06:56,720 the impact of the epidemic was starting 129 00:06:59,270 --> 00:06:58,000 to be felt 130 00:07:01,749 --> 00:06:59,280 uh in 131 00:07:05,830 --> 00:07:03,749 in florida and there were pill mills 132 00:07:07,749 --> 00:07:05,840 there was early reporting that was going 133 00:07:09,029 --> 00:07:07,759 on and there was the beginning of 134 00:07:11,749 --> 00:07:09,039 lawsuits 135 00:07:15,189 --> 00:07:11,759 uh that were starting to happen and i 136 00:07:19,189 --> 00:07:15,199 i looked at the crisis personally 137 00:07:21,990 --> 00:07:19,199 uh when i did a cover story for a 138 00:07:24,629 --> 00:07:22,000 a magazine called city links no no 139 00:07:26,790 --> 00:07:24,639 longer around but it was run by the 140 00:07:28,950 --> 00:07:26,800 south florida sun sentinel and the 141 00:07:30,710 --> 00:07:28,960 tribune company it was a big cover story 142 00:07:32,469 --> 00:07:30,720 and in it i learned just so many 143 00:07:35,909 --> 00:07:32,479 shocking 144 00:07:38,950 --> 00:07:35,919 details so i interviewed a mother whose 145 00:07:41,189 --> 00:07:38,960 son who had a history of addiction and 146 00:07:43,430 --> 00:07:41,199 was on the way to recovery and then had 147 00:07:45,909 --> 00:07:43,440 an injury so he had a history of 148 00:07:48,230 --> 00:07:45,919 addictive behavior and problems then had 149 00:07:51,029 --> 00:07:48,240 an injury was given opioid that was 150 00:07:53,350 --> 00:07:51,039 aggressively marketed to doctors and he 151 00:07:54,869 --> 00:07:53,360 ended up becoming addicted and then 152 00:07:57,990 --> 00:07:54,879 overdosing 153 00:08:00,469 --> 00:07:58,000 and among the details horrifying details 154 00:08:03,430 --> 00:08:00,479 is when she was called down from orlando 155 00:08:06,790 --> 00:08:03,440 to come down to miami when she went to 156 00:08:09,350 --> 00:08:06,800 his home his blood was still drying she 157 00:08:10,390 --> 00:08:09,360 had to walk through her son's drying 158 00:08:13,749 --> 00:08:10,400 blood 159 00:08:16,230 --> 00:08:13,759 to to look at the scene where he died 160 00:08:17,909 --> 00:08:16,240 and then i learned about the power of 161 00:08:21,110 --> 00:08:17,919 the addiction now at this point you need 162 00:08:23,909 --> 00:08:21,120 to understand this is being claimed 163 00:08:26,469 --> 00:08:23,919 uh and there's uh books that 164 00:08:29,350 --> 00:08:26,479 provide an early window into the early 165 00:08:31,430 --> 00:08:29,360 stages of this false marketing so at 166 00:08:34,949 --> 00:08:31,440 that time 167 00:08:37,029 --> 00:08:34,959 purdue and many doctors were claiming 168 00:08:39,430 --> 00:08:37,039 that we needed to look for pain as the 169 00:08:43,110 --> 00:08:39,440 fifth vital sign and they were denying 170 00:08:45,670 --> 00:08:43,120 that oxycontin was heavily addicted okay 171 00:08:47,670 --> 00:08:45,680 i saw with my own eyes when i talked to 172 00:08:49,829 --> 00:08:47,680 people in recovery 173 00:08:53,509 --> 00:08:49,839 people were describing to me what they 174 00:08:55,269 --> 00:08:53,519 would do to get opioids and oxycontin 175 00:08:58,790 --> 00:08:55,279 that included 176 00:09:01,430 --> 00:08:58,800 pulling their own teeth out with pliers 177 00:09:04,230 --> 00:09:01,440 to go into dentist's office so they 178 00:09:06,230 --> 00:09:04,240 could get opioids okay 179 00:09:08,310 --> 00:09:06,240 and people were stabbing themselves in 180 00:09:10,070 --> 00:09:08,320 their arms so they could go to er and 181 00:09:11,509 --> 00:09:10,080 get pain treatment 182 00:09:15,910 --> 00:09:11,519 that's how 183 00:09:18,470 --> 00:09:15,920 powerfully addicted it was and i really 184 00:09:19,910 --> 00:09:18,480 i got very interested in how did how did 185 00:09:21,590 --> 00:09:19,920 that happen 186 00:09:23,829 --> 00:09:21,600 now 187 00:09:24,710 --> 00:09:23,839 what happened in my reporting for my 188 00:09:28,470 --> 00:09:24,720 book 189 00:09:29,670 --> 00:09:28,480 was i i emphasized and looked at the 190 00:09:32,870 --> 00:09:29,680 um 191 00:09:34,870 --> 00:09:32,880 uh i remember i looked at the issue of 192 00:09:37,509 --> 00:09:34,880 how in fact 193 00:09:40,389 --> 00:09:37,519 did all this uh begin and i looked at 194 00:09:43,430 --> 00:09:40,399 the at the corruption that was going on 195 00:09:45,910 --> 00:09:43,440 that allowed over medication of opioids 196 00:09:49,350 --> 00:09:45,920 in the department of veterans affairs 197 00:09:52,870 --> 00:09:49,360 and i i began looking at that and saw 198 00:09:55,030 --> 00:09:52,880 how how that went uh a muck 199 00:09:58,630 --> 00:09:55,040 and there was a lot of corruption so for 200 00:10:01,750 --> 00:09:58,640 in fact the first federal guidelines 201 00:10:04,310 --> 00:10:01,760 about about opioids in general 202 00:10:06,630 --> 00:10:04,320 came from a group of scientists who 203 00:10:09,509 --> 00:10:06,640 worked with the va who got grants from 204 00:10:11,990 --> 00:10:09,519 purdue and other opioid manufacturers at 205 00:10:15,910 --> 00:10:12,000 the va in dod and the first federal 206 00:10:18,710 --> 00:10:15,920 guidelines about opioids in 2003 207 00:10:20,230 --> 00:10:18,720 referred to opioids as quote rarely 208 00:10:22,710 --> 00:10:20,240 addictive 209 00:10:24,949 --> 00:10:22,720 this is crazy guidelines 210 00:10:27,990 --> 00:10:24,959 okay and it's similar to 211 00:10:31,509 --> 00:10:28,000 um what's described in the uh book and 212 00:10:32,630 --> 00:10:31,519 the movie uh dopesick that's now on hulu 213 00:10:34,949 --> 00:10:32,640 which has 214 00:10:37,430 --> 00:10:34,959 accurate reconstructions of the early 215 00:10:39,910 --> 00:10:37,440 days but has a lot of wrong takeaways 216 00:10:43,190 --> 00:10:39,920 about how we solve the problem now 217 00:10:46,069 --> 00:10:43,200 now what what what what happened is uh 218 00:10:48,310 --> 00:10:46,079 the fda for instance uh through a 219 00:10:51,670 --> 00:10:48,320 corrupt relationship the medical 220 00:10:54,230 --> 00:10:51,680 reviewer in the fda added a caveat to 221 00:10:57,670 --> 00:10:54,240 the early label for oxycontin that said 222 00:11:01,350 --> 00:10:57,680 it was less addictive than other opioids 223 00:11:03,910 --> 00:11:01,360 because it supposedly was time released 224 00:11:06,630 --> 00:11:03,920 two years later he gets hired away by 225 00:11:08,470 --> 00:11:06,640 purdue and a delayed bribe to be their 226 00:11:09,990 --> 00:11:08,480 medical director 227 00:11:11,990 --> 00:11:10,000 so there's a lot of connections with the 228 00:11:14,069 --> 00:11:12,000 money the money when you follow the 229 00:11:17,030 --> 00:11:14,079 money there's a lot of shady stuff going 230 00:11:19,110 --> 00:11:17,040 on so so so but what's happened in the 231 00:11:21,750 --> 00:11:19,120 years since just to just 232 00:11:24,310 --> 00:11:21,760 move ahead briefly and then is is 233 00:11:26,630 --> 00:11:24,320 prescriptions have fallen about 234 00:11:29,829 --> 00:11:26,640 depending on how you measure it up to 60 235 00:11:32,470 --> 00:11:29,839 percent for opioids in the last decade 236 00:11:36,310 --> 00:11:32,480 and yet overdoses are skyrocketing and 237 00:11:40,790 --> 00:11:36,320 last year we have of all drugs okay 238 00:11:43,750 --> 00:11:40,800 for all drugs we had a 94 000 overdose 239 00:11:46,470 --> 00:11:43,760 deaths in 2020 okay 240 00:11:49,670 --> 00:11:46,480 clearly and even though prescribing for 241 00:11:51,350 --> 00:11:49,680 opioids has been gone down 242 00:11:55,110 --> 00:11:51,360 so dramatically 243 00:11:56,870 --> 00:11:55,120 opioid fatalities 244 00:11:59,829 --> 00:11:56,880 rose nearly 40 245 00:12:02,949 --> 00:11:59,839 last year so clearly whatever we think 246 00:12:06,310 --> 00:12:02,959 we're doing isn't working at all and is 247 00:12:09,430 --> 00:12:06,320 accentuating harm and that's why 248 00:12:11,910 --> 00:12:09,440 uh i'm following the lead of such uh 249 00:12:15,670 --> 00:12:11,920 pioneer journalists as mayas olivet who 250 00:12:17,750 --> 00:12:15,680 knew whose new book is uh undoing drugs 251 00:12:20,389 --> 00:12:17,760 uh about the importance of harm 252 00:12:22,790 --> 00:12:20,399 reduction and that should be the guiding 253 00:12:25,670 --> 00:12:22,800 principle derived from the hippocratic 254 00:12:28,150 --> 00:12:25,680 oath of medicine first do no harm harm 255 00:12:31,110 --> 00:12:28,160 yeah and everything about our drug 256 00:12:33,750 --> 00:12:31,120 policies for both people with substance 257 00:12:36,069 --> 00:12:33,760 abuse disorders and chronic pain 258 00:12:38,310 --> 00:12:36,079 is crazy 259 00:12:41,670 --> 00:12:38,320 and insane i kind of feel like the 260 00:12:44,790 --> 00:12:41,680 history of american drug policy 261 00:12:47,910 --> 00:12:44,800 starting in the early 20th century with 262 00:12:50,230 --> 00:12:47,920 uh classifying drugs and there was a is 263 00:12:51,829 --> 00:12:50,240 is basically like a horror movie you 264 00:12:54,470 --> 00:12:51,839 know when you're watching a horror movie 265 00:12:55,990 --> 00:12:54,480 and you see the young innocent teenagers 266 00:12:58,230 --> 00:12:56,000 they're going to go into the room where 267 00:13:00,710 --> 00:12:58,240 the killer is and you go no no don't do 268 00:13:03,670 --> 00:13:00,720 that that that's essentially every 269 00:13:05,670 --> 00:13:03,680 single decision our government our 270 00:13:08,150 --> 00:13:05,680 insurance policies and our clinicians 271 00:13:11,030 --> 00:13:08,160 have made for a hundred years has always 272 00:13:11,829 --> 00:13:11,040 been wrong and has led to more harm it's 273 00:13:14,230 --> 00:13:11,839 just 274 00:13:16,870 --> 00:13:14,240 out it's so bad 275 00:13:19,030 --> 00:13:16,880 and there are ways to get out of this 276 00:13:20,949 --> 00:13:19,040 mess unfortunately they're not being 277 00:13:22,949 --> 00:13:20,959 followed as well as much as they should 278 00:13:25,590 --> 00:13:22,959 be 279 00:13:28,150 --> 00:13:25,600 well so you know let's let's get into 280 00:13:30,389 --> 00:13:28,160 the the origins of some of this some of 281 00:13:31,990 --> 00:13:30,399 these drugs like oxycontin what what can 282 00:13:34,790 --> 00:13:32,000 you tell us about the origins of 283 00:13:37,350 --> 00:13:34,800 oxycontin and how they aggress so 284 00:13:40,310 --> 00:13:37,360 aggressively we're able to market it to 285 00:13:43,269 --> 00:13:40,320 doctors and even incentivize doctors to 286 00:13:45,910 --> 00:13:43,279 write more prescriptions right well it 287 00:13:49,030 --> 00:13:45,920 it it is uh it's it's in books like 288 00:13:51,269 --> 00:13:49,040 dreamland and books like uh 289 00:13:53,829 --> 00:13:51,279 dopesick which is now the hulu series 290 00:13:55,990 --> 00:13:53,839 it's relatively accurate about the early 291 00:13:58,710 --> 00:13:56,000 days so essentially 292 00:13:59,750 --> 00:13:58,720 this was a company owned by the sackler 293 00:14:01,670 --> 00:13:59,760 family 294 00:14:03,350 --> 00:14:01,680 that was a relatively smaller company 295 00:14:05,509 --> 00:14:03,360 called purdue 296 00:14:07,110 --> 00:14:05,519 and and what happened is they had a 297 00:14:10,550 --> 00:14:07,120 short acting 298 00:14:12,870 --> 00:14:10,560 uh drug that was legitimate called ms 299 00:14:14,470 --> 00:14:12,880 cotton and then they worked at a 300 00:14:17,750 --> 00:14:14,480 formulation 301 00:14:19,189 --> 00:14:17,760 for a longer acting drug and then they 302 00:14:21,030 --> 00:14:19,199 realized oh 303 00:14:23,990 --> 00:14:21,040 you know they they would be able to have 304 00:14:26,629 --> 00:14:24,000 higher dosages but to be over time and 305 00:14:28,629 --> 00:14:26,639 they would claim they claimed that oh 306 00:14:30,790 --> 00:14:28,639 the last 12 hours people could sleep 307 00:14:34,150 --> 00:14:30,800 through the night very early on they 308 00:14:36,389 --> 00:14:34,160 realized that they were not actually 309 00:14:38,470 --> 00:14:36,399 lasting 12 hours and the addictive 310 00:14:40,150 --> 00:14:38,480 potential was very high 311 00:14:42,470 --> 00:14:40,160 uh and but they 312 00:14:46,069 --> 00:14:42,480 they came up with the meme 313 00:14:48,790 --> 00:14:46,079 it's a kind of a crazy detail but they 314 00:14:50,150 --> 00:14:48,800 came up with a meme and point of view 315 00:14:53,030 --> 00:14:50,160 which is 316 00:14:56,870 --> 00:14:53,040 opioids in general and oxycontin in 317 00:14:58,949 --> 00:14:56,880 particular have less than a one percent 318 00:15:00,790 --> 00:14:58,959 addictive potential so that was the 319 00:15:02,470 --> 00:15:00,800 claim there i couldn't believe that when 320 00:15:04,710 --> 00:15:02,480 i heard it in this dopestick thing right 321 00:15:07,269 --> 00:15:04,720 i couldn't believe that 322 00:15:09,870 --> 00:15:07,279 here are the origins of that it's called 323 00:15:12,710 --> 00:15:09,880 the jinx letter which is written at the 324 00:15:15,030 --> 00:15:12,720 mid-1980s it's a letter from guys based 325 00:15:16,470 --> 00:15:15,040 in a hospital to i believe is the new 326 00:15:20,069 --> 00:15:16,480 england journal it's called the jinx 327 00:15:23,590 --> 00:15:20,079 letter it was j-i-n-k-s i think anyway 328 00:15:24,470 --> 00:15:23,600 five sentences in a letter 329 00:15:26,389 --> 00:15:24,480 to 330 00:15:28,710 --> 00:15:26,399 uh jama okay 331 00:15:30,710 --> 00:15:28,720 and what did that letter say five 332 00:15:33,829 --> 00:15:30,720 sentences were 333 00:15:35,189 --> 00:15:33,839 we've been treating patients with acute 334 00:15:37,829 --> 00:15:35,199 pain 335 00:15:40,790 --> 00:15:37,839 in our hospital and we've been giving 336 00:15:43,110 --> 00:15:40,800 them opioids and we find and we give 337 00:15:45,590 --> 00:15:43,120 them you know presumably some a little 338 00:15:49,030 --> 00:15:45,600 amount when they are discharged and we 339 00:15:51,030 --> 00:15:49,040 find that less than one percent of the 340 00:15:53,990 --> 00:15:51,040 acute 341 00:15:57,350 --> 00:15:54,000 pain people emerging from a hospital 342 00:16:00,790 --> 00:15:57,360 become addicted so that what that became 343 00:16:03,670 --> 00:16:00,800 this fig leaf for this massive 344 00:16:05,430 --> 00:16:03,680 publicity and pr campaign so this five 345 00:16:07,749 --> 00:16:05,440 sentence letter 346 00:16:10,310 --> 00:16:07,759 then began to be referred to by the 347 00:16:11,269 --> 00:16:10,320 salesman of purdue 348 00:16:13,910 --> 00:16:11,279 as 349 00:16:16,790 --> 00:16:13,920 a major study in the journal of the 350 00:16:19,350 --> 00:16:16,800 american medical association meaning it 351 00:16:20,310 --> 00:16:19,360 wasn't the peer-reviewed study 352 00:16:23,430 --> 00:16:20,320 you know 353 00:16:26,790 --> 00:16:23,440 the actual addiction potential if you 354 00:16:28,949 --> 00:16:26,800 don't uh screen for people's backgrounds 355 00:16:31,269 --> 00:16:28,959 for chronic pain patients may be in the 356 00:16:33,110 --> 00:16:31,279 eight percent range according to 357 00:16:34,870 --> 00:16:33,120 including some people who are the head 358 00:16:35,749 --> 00:16:34,880 of the national institute of drug abuse 359 00:16:37,670 --> 00:16:35,759 now 360 00:16:39,350 --> 00:16:37,680 so it is still 361 00:16:42,150 --> 00:16:39,360 for people with chronic pain the 362 00:16:45,590 --> 00:16:42,160 addiction potential is not as great 363 00:16:48,949 --> 00:16:45,600 um as is commonly believed but obviously 364 00:16:51,910 --> 00:16:48,959 it's there now what happened was 365 00:16:54,470 --> 00:16:51,920 the the level of fault is 366 00:16:57,670 --> 00:16:54,480 every single institution 367 00:16:59,749 --> 00:16:57,680 failed and money played the role 368 00:17:01,350 --> 00:16:59,759 so it's sort of hard to believe but 369 00:17:03,269 --> 00:17:01,360 basically well it's not hard to believe 370 00:17:04,549 --> 00:17:03,279 it's the reporting has come out and all 371 00:17:05,669 --> 00:17:04,559 the litigation 372 00:17:08,390 --> 00:17:05,679 purdue 373 00:17:10,630 --> 00:17:08,400 had to pay out like you know 374 00:17:12,309 --> 00:17:10,640 over you know three billion or four 375 00:17:14,630 --> 00:17:12,319 billion dollars in a settlement but 376 00:17:17,029 --> 00:17:14,640 nobody went to jail in the top 377 00:17:19,029 --> 00:17:17,039 leadership uh and they had this 378 00:17:20,630 --> 00:17:19,039 settlement and they went into bankruptcy 379 00:17:23,590 --> 00:17:20,640 and part of the deal was they couldn't 380 00:17:25,510 --> 00:17:23,600 go after the actual sackler family 381 00:17:27,029 --> 00:17:25,520 members who were still alive who drove 382 00:17:30,230 --> 00:17:27,039 this policy 383 00:17:32,789 --> 00:17:30,240 but the craziness here is 384 00:17:35,669 --> 00:17:32,799 they managed to corrupt 385 00:17:37,669 --> 00:17:35,679 everybody it's like yeah it's like a 386 00:17:39,909 --> 00:17:37,679 dominoes right they all felt every 387 00:17:42,390 --> 00:17:39,919 institution and safeguard just felt like 388 00:17:45,990 --> 00:17:42,400 dominoes one after yeah so so they 389 00:17:48,789 --> 00:17:46,000 created a series of myths like uh 390 00:17:51,430 --> 00:17:48,799 there's objective measurement for pain 391 00:17:55,270 --> 00:17:51,440 pain is very subjective so they created 392 00:17:57,270 --> 00:17:55,280 a a one to ten chart of smiling faces 393 00:18:00,470 --> 00:17:57,280 and unhappy faces and you would pick 394 00:18:04,070 --> 00:18:00,480 inside a hospital room where it would 395 00:18:06,710 --> 00:18:04,080 and they took they created front group 396 00:18:10,630 --> 00:18:06,720 pain societies with quote independent 397 00:18:13,990 --> 00:18:10,640 doctors who they either created or 398 00:18:17,029 --> 00:18:14,000 funded or subsidized in fuller part to 399 00:18:19,990 --> 00:18:17,039 be independent experts so they created 400 00:18:21,830 --> 00:18:20,000 and then of course they paid doctors and 401 00:18:24,630 --> 00:18:21,840 this is this is a trick that they 402 00:18:27,909 --> 00:18:24,640 learned they learned from the 403 00:18:30,950 --> 00:18:27,919 marketers like pfizer and astrazeneca 404 00:18:33,190 --> 00:18:30,960 and others for from psychoactive drugs 405 00:18:34,470 --> 00:18:33,200 you know like seroquel and 406 00:18:36,710 --> 00:18:34,480 and uh 407 00:18:38,789 --> 00:18:36,720 and risperdal and all those things this 408 00:18:41,270 --> 00:18:38,799 is a trick you pay 409 00:18:44,549 --> 00:18:41,280 you find hacks 410 00:18:48,070 --> 00:18:44,559 to craft medical studies and then you 411 00:18:49,270 --> 00:18:48,080 get a big a big deal academic to sign 412 00:18:51,029 --> 00:18:49,280 off 413 00:18:53,830 --> 00:18:51,039 and then they get it of course these 414 00:18:55,590 --> 00:18:53,840 people are all paid for their work 415 00:18:58,150 --> 00:18:55,600 supporting the conclusions the drug 416 00:19:00,710 --> 00:18:58,160 industry wants right right absolutely i 417 00:19:01,510 --> 00:19:00,720 mean there there's studies that show 418 00:19:02,470 --> 00:19:01,520 that 419 00:19:04,470 --> 00:19:02,480 um 420 00:19:07,110 --> 00:19:04,480 and it wasn't until and it's still not 421 00:19:08,630 --> 00:19:07,120 widely of enforced 422 00:19:10,630 --> 00:19:08,640 that uh 423 00:19:12,870 --> 00:19:10,640 for years and years and years people 424 00:19:14,870 --> 00:19:12,880 didn't disclose and then when they 425 00:19:17,270 --> 00:19:14,880 disclosed who was paying for them or 426 00:19:20,070 --> 00:19:17,280 they lied about it and it is still very 427 00:19:23,510 --> 00:19:20,080 weakly enforced but so what happens is 428 00:19:26,150 --> 00:19:23,520 they find big name academics to write 429 00:19:28,710 --> 00:19:26,160 articles with their prestige for quote 430 00:19:32,150 --> 00:19:28,720 peer-reviewed journals many of whom are 431 00:19:34,870 --> 00:19:32,160 also getting drug drug money okay and 432 00:19:38,150 --> 00:19:34,880 then say how wonderful these drugs are 433 00:19:39,350 --> 00:19:38,160 and then it sort of spreads out and but 434 00:19:44,549 --> 00:19:39,360 they also 435 00:19:46,789 --> 00:19:44,559 commission which is the kind of general 436 00:19:49,750 --> 00:19:46,799 health care thing uh organization for 437 00:19:51,909 --> 00:19:49,760 hospitals and they themselves would be 438 00:19:53,510 --> 00:19:51,919 endorsing and promoting the use of 439 00:19:55,270 --> 00:19:53,520 opioids 440 00:19:57,590 --> 00:19:55,280 in hospitals 441 00:19:59,909 --> 00:19:57,600 and then and then the it was just like 442 00:20:01,990 --> 00:19:59,919 and then and then the worst of it it's 443 00:20:05,590 --> 00:20:02,000 hard to say like who are the worst 444 00:20:08,950 --> 00:20:05,600 players my view about all of this is 445 00:20:11,430 --> 00:20:08,960 there is a comedic novel from the 1960s 446 00:20:14,230 --> 00:20:11,440 called the magic christian written by 447 00:20:15,909 --> 00:20:14,240 terry southern and the comedic premise 448 00:20:18,310 --> 00:20:15,919 of the book was later made into a movie 449 00:20:22,710 --> 00:20:18,320 with peter sellers and ringo starr is 450 00:20:24,549 --> 00:20:22,720 money can corrupt anyone to do anything 451 00:20:25,990 --> 00:20:24,559 and they would he would do things in the 452 00:20:28,789 --> 00:20:26,000 novel like 453 00:20:30,630 --> 00:20:28,799 the biggest prize fight in britain 454 00:20:32,230 --> 00:20:30,640 and this is when everybody is very 455 00:20:34,470 --> 00:20:32,240 homophobic and he'd have the two 456 00:20:36,950 --> 00:20:34,480 heavyweight champions come out and he'd 457 00:20:39,430 --> 00:20:36,960 pay them millions to start making out 458 00:20:43,110 --> 00:20:39,440 and kissing in the middle of a televised 459 00:20:45,669 --> 00:20:43,120 prize fight just for giggles so that we 460 00:20:47,510 --> 00:20:45,679 had the point was people will do 461 00:20:51,430 --> 00:20:47,520 anything for money 462 00:20:54,950 --> 00:20:51,440 money drove so much of this bad policy 463 00:20:56,390 --> 00:20:54,960 which then influenced um unfortunately 464 00:21:00,149 --> 00:20:56,400 doctors 465 00:21:03,190 --> 00:21:00,159 and and so but one of the worst players 466 00:21:07,110 --> 00:21:03,200 is beside the fda giving this 467 00:21:09,669 --> 00:21:07,120 bogus letter the fda claiming with no 468 00:21:11,510 --> 00:21:09,679 research based on negotiating with 469 00:21:14,630 --> 00:21:11,520 purdue lobbyists 470 00:21:17,590 --> 00:21:14,640 okay behind the scenes no evidence it's 471 00:21:20,870 --> 00:21:17,600 less addictive because a purdue ex a 472 00:21:21,669 --> 00:21:20,880 lobbyist tells the fda 473 00:21:28,390 --> 00:21:21,679 that 474 00:21:31,110 --> 00:21:28,400 less addictive because it's time 475 00:21:33,270 --> 00:21:31,120 released the fd goes yep we agree 476 00:21:34,310 --> 00:21:33,280 and i found that when i was looking at 477 00:21:37,909 --> 00:21:34,320 the 478 00:21:39,990 --> 00:21:37,919 expansion of marketing and 479 00:21:42,230 --> 00:21:40,000 for the um 480 00:21:46,070 --> 00:21:42,240 for the different um 481 00:21:48,470 --> 00:21:46,080 groups uh for anti-psychotic drugs but 482 00:21:51,990 --> 00:21:48,480 then the dea itself 483 00:21:54,070 --> 00:21:52,000 the dea basically did nothing 484 00:21:57,110 --> 00:21:54,080 whatsoever 485 00:22:00,470 --> 00:21:57,120 and it's for years and years and years 486 00:22:02,149 --> 00:22:00,480 as they let they let these massive over 487 00:22:05,510 --> 00:22:02,159 supplies 488 00:22:07,190 --> 00:22:05,520 go on and on and on in in these 489 00:22:10,310 --> 00:22:07,200 particularly in these happily 490 00:22:12,950 --> 00:22:10,320 appalachian hill towns and smaller areas 491 00:22:14,950 --> 00:22:12,960 they did nothing so there's a new book 492 00:22:19,350 --> 00:22:14,960 out by a uh 493 00:22:22,710 --> 00:22:19,360 uh a charleston gazette journalist uh 494 00:22:27,029 --> 00:22:22,720 about a town small town in west virginia 495 00:22:29,430 --> 00:22:27,039 that uh basically uh got 496 00:22:31,830 --> 00:22:29,440 basically got like 400 people and 4 497 00:22:34,390 --> 00:22:31,840 million pills over several years because 498 00:22:35,430 --> 00:22:34,400 it was clearly a diversion center 499 00:22:44,630 --> 00:22:35,440 and 500 00:22:46,549 --> 00:22:44,640 is money will get you anything so purdue 501 00:22:49,669 --> 00:22:46,559 and the other opioid had a brilliant 502 00:22:52,950 --> 00:22:49,679 idea why don't we go into 503 00:22:56,870 --> 00:22:52,960 the actual dea council's office and 504 00:22:58,789 --> 00:22:56,880 start hiring them away to work for us 505 00:23:00,789 --> 00:22:58,799 yeah so then you've got all the deas 506 00:23:02,310 --> 00:23:00,799 working for them and their buddies with 507 00:23:04,390 --> 00:23:02,320 they're still friends with the people 508 00:23:06,710 --> 00:23:04,400 that are still running this right yeah 509 00:23:10,630 --> 00:23:06,720 so they get a pass yeah you get okay so 510 00:23:12,149 --> 00:23:10,640 they they that is very similar to 511 00:23:14,310 --> 00:23:12,159 in general there's a book ad called 512 00:23:16,470 --> 00:23:14,320 dirty money which looks at the failure 513 00:23:19,029 --> 00:23:16,480 of any white collar 514 00:23:21,830 --> 00:23:19,039 uh criminals to ever go to prison for 515 00:23:24,310 --> 00:23:21,840 anything that's a general rule of thumb 516 00:23:26,470 --> 00:23:24,320 and my solution is what i call the bubba 517 00:23:28,950 --> 00:23:26,480 solution is get some white collar 518 00:23:31,430 --> 00:23:28,960 executives in a jail cell with a guy 519 00:23:32,950 --> 00:23:31,440 named bubba for about 520 00:23:35,350 --> 00:23:32,960 a solution 521 00:23:38,310 --> 00:23:35,360 and then get it publicized and you might 522 00:23:40,630 --> 00:23:38,320 see a reduction in white-collar crime 523 00:23:43,430 --> 00:23:40,640 across the board and a lot of it of 524 00:23:47,590 --> 00:23:43,440 course is in the uh 525 00:23:50,710 --> 00:23:47,600 the drug field in fact so the d.a gutted 526 00:23:52,710 --> 00:23:50,720 enforcement by hiring it away and then 527 00:23:55,029 --> 00:23:52,720 in 2016 528 00:23:57,029 --> 00:23:55,039 when it was really obvious and raging 529 00:23:59,269 --> 00:23:57,039 there was a law passed 530 00:24:00,950 --> 00:23:59,279 that uh and 60 minutes did show in this 531 00:24:03,269 --> 00:24:00,960 there was a law passed that kind of 532 00:24:06,390 --> 00:24:03,279 snuck through congress that tied the 533 00:24:08,789 --> 00:24:06,400 hands of the dea to enforce opioid 534 00:24:12,070 --> 00:24:08,799 limits in any meaningful way 535 00:24:13,590 --> 00:24:12,080 okay but what happened subsequently is 536 00:24:14,549 --> 00:24:13,600 the dea 537 00:24:16,950 --> 00:24:14,559 now 538 00:24:19,909 --> 00:24:16,960 has devolved into 539 00:24:22,630 --> 00:24:19,919 a pretty dangerous operation because 540 00:24:25,430 --> 00:24:22,640 they helped accentuate the opioid 541 00:24:28,149 --> 00:24:25,440 epidemic by doing nothing now they're 542 00:24:31,110 --> 00:24:28,159 going overboard and they're going 543 00:24:34,230 --> 00:24:31,120 overboard in this regard they are the 544 00:24:38,710 --> 00:24:34,240 deciders of who is prescribing 545 00:24:41,510 --> 00:24:38,720 legitimately opioids for chronic pain 546 00:24:43,750 --> 00:24:41,520 and they're driving down the d.a 547 00:24:46,149 --> 00:24:43,760 made up of these hardcore law 548 00:24:49,430 --> 00:24:46,159 enforcement people with no medical 549 00:24:50,470 --> 00:24:49,440 knowledge are driving down 550 00:24:53,669 --> 00:24:50,480 the 551 00:24:56,950 --> 00:24:53,679 prescribing of opioids and helping 552 00:24:59,110 --> 00:24:56,960 threaten and force good doctors out of 553 00:25:00,950 --> 00:24:59,120 the medical field with the threat of 554 00:25:02,390 --> 00:25:00,960 prosecution or the reality of 555 00:25:03,669 --> 00:25:02,400 prosecution 556 00:25:09,110 --> 00:25:03,679 plus 557 00:25:13,029 --> 00:25:09,120 further stigmatizing the notion 558 00:25:14,950 --> 00:25:13,039 of prescribing any opioids and this is 559 00:25:16,710 --> 00:25:14,960 something being looked at by the health 560 00:25:18,950 --> 00:25:16,720 justice lab out of 561 00:25:20,789 --> 00:25:18,960 northeastern university uh with under 562 00:25:22,310 --> 00:25:20,799 the direction of uh law professor leo 563 00:25:24,870 --> 00:25:22,320 biletsky is 564 00:25:28,230 --> 00:25:24,880 homicide prosecutions 565 00:25:31,590 --> 00:25:28,240 for doctors acting in good faith who are 566 00:25:34,470 --> 00:25:31,600 prescribing opioids if anybody dies they 567 00:25:36,950 --> 00:25:34,480 then prosecute them for murder and then 568 00:25:39,909 --> 00:25:36,960 also they're prosecuting you know 569 00:25:41,990 --> 00:25:39,919 someone who's in the group of shooters 570 00:25:43,750 --> 00:25:42,000 when someone is shooting up and dies so 571 00:25:46,149 --> 00:25:43,760 they're using this 572 00:25:49,750 --> 00:25:46,159 like scare tactic and it's not at all 573 00:25:53,350 --> 00:25:49,760 reducing opioids but the dea right now 574 00:25:54,470 --> 00:25:53,360 is it it basically and in her new book 575 00:26:00,870 --> 00:25:54,480 uh 576 00:26:03,430 --> 00:26:00,880 what we're seeing also with the rise of 577 00:26:06,149 --> 00:26:03,440 the black lives matter movement is just 578 00:26:09,430 --> 00:26:06,159 how much law enforcement is tied into 579 00:26:11,190 --> 00:26:09,440 this kind of racial enforcement of drugs 580 00:26:14,630 --> 00:26:11,200 so basically 581 00:26:16,549 --> 00:26:14,640 uh blacks are jailed like six times more 582 00:26:19,430 --> 00:26:16,559 than white people for the same drug 583 00:26:22,310 --> 00:26:19,440 offenses i mean it's really outrageous 584 00:26:25,830 --> 00:26:22,320 so the dea at this point is 585 00:26:28,630 --> 00:26:25,840 after letting opioid addiction run amok 586 00:26:30,549 --> 00:26:28,640 uh and then doing nothing and then 587 00:26:33,110 --> 00:26:30,559 shilling for the drug industry by having 588 00:26:35,590 --> 00:26:33,120 their lawyers and agents go work for the 589 00:26:38,390 --> 00:26:35,600 drug industry now they're stopping 590 00:26:41,269 --> 00:26:38,400 doctors from prescribing both boxing 591 00:26:42,870 --> 00:26:41,279 they often in some cases prosecute them 592 00:26:45,909 --> 00:26:42,880 because they're prescribing too much 593 00:26:48,789 --> 00:26:45,919 suboxone or for pain patients and 594 00:26:52,390 --> 00:26:48,799 suboxone is buprenephrine uh that's the 595 00:26:54,470 --> 00:26:52,400 easier it's the it's the it's the uh 596 00:26:56,710 --> 00:26:54,480 that's the brand name and suboxone 597 00:26:59,110 --> 00:26:56,720 they're prosecuting some of them for 598 00:27:01,750 --> 00:26:59,120 doing that as well as patients and then 599 00:27:04,870 --> 00:27:01,760 what's the other thing they do they kick 600 00:27:07,430 --> 00:27:04,880 down the doors of black people and help 601 00:27:09,190 --> 00:27:07,440 shoot them under suspected warrants of 602 00:27:11,669 --> 00:27:09,200 being drug dealers i mean that's 603 00:27:12,870 --> 00:27:11,679 basically their main function sort of 604 00:27:15,190 --> 00:27:12,880 jump out 605 00:27:16,390 --> 00:27:15,200 uh you know chasing down people with 606 00:27:18,389 --> 00:27:16,400 warrants 607 00:27:20,149 --> 00:27:18,399 heavily militarized which is also 608 00:27:21,590 --> 00:27:20,159 influencing how police departments 609 00:27:23,669 --> 00:27:21,600 handle drugs 610 00:27:25,669 --> 00:27:23,679 and you know prosecuting 611 00:27:27,590 --> 00:27:25,679 usually well-meaning that doesn't mean 612 00:27:30,549 --> 00:27:27,600 there aren't totally irresponsible 613 00:27:32,389 --> 00:27:30,559 doctors who are still engaging in pill 614 00:27:36,230 --> 00:27:32,399 mill type behavior deserve to be 615 00:27:40,149 --> 00:27:36,240 prosecuted so the whole thing is 616 00:27:42,230 --> 00:27:40,159 horribly done on every front 617 00:27:44,549 --> 00:27:42,240 yeah and can we talk a little bit about 618 00:27:46,710 --> 00:27:44,559 the lobbying that goes on in washington 619 00:27:48,870 --> 00:27:46,720 and what part do you think that that 620 00:27:50,470 --> 00:27:48,880 plays in it because i've often thought 621 00:27:52,310 --> 00:27:50,480 like the senators should have to wear 622 00:27:55,190 --> 00:27:52,320 like race car drivers you know like but 623 00:27:58,070 --> 00:27:55,200 you have to have a fiser on their suit 624 00:28:00,389 --> 00:27:58,080 or you know purdue over here we have you 625 00:28:02,149 --> 00:28:00,399 know so that we know who bought and paid 626 00:28:03,750 --> 00:28:02,159 for these people that are allowing this 627 00:28:06,950 --> 00:28:03,760 to continue i always thought that was a 628 00:28:08,149 --> 00:28:06,960 great idea to show i mean the lobbying 629 00:28:10,630 --> 00:28:08,159 um 630 00:28:12,630 --> 00:28:10,640 it is there's there's always something 631 00:28:14,549 --> 00:28:12,640 that they want to do 632 00:28:17,990 --> 00:28:14,559 and so they lobby 633 00:28:21,430 --> 00:28:18,000 uh i don't have the latest uh big pharma 634 00:28:22,789 --> 00:28:21,440 lobbying things but i learned uh about 635 00:28:25,029 --> 00:28:22,799 the big 636 00:28:28,149 --> 00:28:25,039 lobbying occurs not just in congress but 637 00:28:29,909 --> 00:28:28,159 on regulatory agencies so one of the key 638 00:28:31,990 --> 00:28:29,919 things there was an important study that 639 00:28:35,430 --> 00:28:32,000 came out several years ago 640 00:28:39,830 --> 00:28:37,590 health research group by the ralph nader 641 00:28:42,710 --> 00:28:39,840 organization public citizen health so 642 00:28:45,750 --> 00:28:42,720 they found over the last 25 years drug 643 00:28:47,510 --> 00:28:45,760 companies have paid out 35 billion 644 00:28:50,389 --> 00:28:47,520 dollars in different fines and 645 00:28:53,190 --> 00:28:50,399 settlements this is so crazy yeah but 646 00:28:55,190 --> 00:28:53,200 more than defense departments 647 00:28:57,350 --> 00:28:55,200 defense contractors it used to be the 648 00:29:01,430 --> 00:28:57,360 earlier big fraudsters 649 00:29:04,630 --> 00:29:01,440 now to drug companies the key point is 650 00:29:06,950 --> 00:29:04,640 that they never get meaningfully public 651 00:29:10,789 --> 00:29:06,960 punished so in all these settlements and 652 00:29:13,909 --> 00:29:10,799 i dug into this they're referred to the 653 00:29:17,830 --> 00:29:13,919 inspector general's office of hhs to 654 00:29:20,230 --> 00:29:17,840 monitor the settlement and they always 655 00:29:22,870 --> 00:29:20,240 ignore the settlement 656 00:29:25,350 --> 00:29:22,880 over and over and over again there's no 657 00:29:28,389 --> 00:29:25,360 meaningful consequence so i literally 658 00:29:31,430 --> 00:29:28,399 and this uh when i was drilling into why 659 00:29:34,470 --> 00:29:31,440 why is it that pfizer astrazeneca almost 660 00:29:36,789 --> 00:29:34,480 every company was repeatedly fined in 661 00:29:39,510 --> 00:29:36,799 the billions i'm not talking about the 662 00:29:41,750 --> 00:29:39,520 opioids but psychoactive drugs you know 663 00:29:44,230 --> 00:29:41,760 for violating off-label marketing 664 00:29:46,549 --> 00:29:44,240 claiming you know that that uh this 665 00:29:50,389 --> 00:29:46,559 antipsychotic could 666 00:29:53,029 --> 00:29:50,399 cure anxiety or something you know and i 667 00:29:54,950 --> 00:29:53,039 i actually spoke with the inspector a 668 00:29:57,510 --> 00:29:54,960 guy from the inspector general's office 669 00:30:00,630 --> 00:29:57,520 and this is representative of the entire 670 00:30:01,750 --> 00:30:00,640 government so i spoke to this guy and i 671 00:30:04,310 --> 00:30:01,760 said 672 00:30:05,430 --> 00:30:04,320 so what what have you done 673 00:30:09,029 --> 00:30:05,440 to uh 674 00:30:11,590 --> 00:30:09,039 you know hold to account any of the drug 675 00:30:14,870 --> 00:30:11,600 companies who violate agreements that 676 00:30:17,510 --> 00:30:14,880 you're supposed to be enforced and he 677 00:30:18,310 --> 00:30:17,520 said can you give me an example and he 678 00:30:22,549 --> 00:30:18,320 said 679 00:30:25,909 --> 00:30:22,559 let me get back to you so then wow 680 00:30:29,269 --> 00:30:25,919 later he quote got back to me and he 681 00:30:31,269 --> 00:30:29,279 found something a decade earlier which 682 00:30:32,230 --> 00:30:31,279 they find somebody 683 00:30:35,590 --> 00:30:32,240 three 684 00:30:38,149 --> 00:30:35,600 thousand dollars now if you make 685 00:30:40,950 --> 00:30:38,159 like you know tens of billions of 686 00:30:42,230 --> 00:30:40,960 dollars you know over the patented life 687 00:30:44,149 --> 00:30:42,240 of a drug 688 00:30:45,750 --> 00:30:44,159 you know even a two year that little bit 689 00:30:46,870 --> 00:30:45,760 of that's a slap on the wrist they'll 690 00:30:48,389 --> 00:30:46,880 just yeah 691 00:30:51,110 --> 00:30:48,399 it's part of the cost of doing business 692 00:30:53,830 --> 00:30:51,120 for them 693 00:30:55,669 --> 00:30:53,840 they're so rich that even these 694 00:30:58,950 --> 00:30:55,679 settlements that you know are covered in 695 00:31:01,909 --> 00:30:58,960 the news like pfizer paid 2.3 billion 696 00:31:04,070 --> 00:31:01,919 dollars for false marketing or over 3 697 00:31:06,389 --> 00:31:04,080 billion whatever the exact figure is the 698 00:31:09,190 --> 00:31:06,399 news you know this is amazing oh we're 699 00:31:10,230 --> 00:31:09,200 getting tough well if you're making per 700 00:31:12,789 --> 00:31:10,240 drug 701 00:31:15,110 --> 00:31:12,799 let's say 5 billion on the psychoactive 702 00:31:17,750 --> 00:31:15,120 drugs it's much higher for purdue on 703 00:31:21,990 --> 00:31:17,760 oxycontin let's say you make five 704 00:31:25,430 --> 00:31:22,000 billion dollars as astrazeneca 705 00:31:27,590 --> 00:31:25,440 what did astrazeneca did on its seroquel 706 00:31:30,389 --> 00:31:27,600 which later shown to have 707 00:31:32,470 --> 00:31:30,399 really high risk of uh art heart 708 00:31:34,870 --> 00:31:32,480 arrhythmias and was causing needless 709 00:31:37,430 --> 00:31:34,880 deaths of veterans and others 710 00:31:39,990 --> 00:31:37,440 you get 5 billion a year 711 00:31:42,389 --> 00:31:40,000 for 17 years 712 00:31:45,110 --> 00:31:42,399 that's how long the patent lasts so at 713 00:31:48,549 --> 00:31:45,120 the end of your crime spree and your 714 00:31:52,070 --> 00:31:48,559 false marketing somebody catches up with 715 00:31:55,029 --> 00:31:52,080 you would say uh oh boy we want the we 716 00:31:57,750 --> 00:31:55,039 want the two billion dollars you know i 717 00:32:00,389 --> 00:31:57,760 mean who cares it's like chump change it 718 00:32:02,389 --> 00:32:00,399 is literally called chump change it's 719 00:32:03,909 --> 00:32:02,399 it's very similar to to the stuff about 720 00:32:05,990 --> 00:32:03,919 people on wall street who get caught 721 00:32:08,310 --> 00:32:06,000 with insider training trading and they 722 00:32:10,230 --> 00:32:08,320 give them a fine you know they make 300 723 00:32:13,110 --> 00:32:10,240 million dollars doing something dirty 724 00:32:14,789 --> 00:32:13,120 and then the fcc finds them you know a 725 00:32:17,190 --> 00:32:14,799 half a million dollars or something they 726 00:32:18,950 --> 00:32:17,200 still got away with all that the the 727 00:32:21,110 --> 00:32:18,960 difference of the money you know oh yeah 728 00:32:23,430 --> 00:32:21,120 and one of the reasons it's very similar 729 00:32:26,310 --> 00:32:23,440 to the hollowing out of the dea by 730 00:32:28,230 --> 00:32:26,320 purdue by taking the lawyers and matt 731 00:32:30,070 --> 00:32:28,240 tavaye did a lot of good reporting about 732 00:32:32,950 --> 00:32:30,080 this for rolling stone in the white 733 00:32:33,990 --> 00:32:32,960 collar financial crime industry 734 00:32:37,590 --> 00:32:34,000 and 735 00:32:40,149 --> 00:32:37,600 what what happened is uh so many of the 736 00:32:42,070 --> 00:32:40,159 sec lawyers got hired away by the 737 00:32:44,470 --> 00:32:42,080 defense people and they still knew 738 00:32:46,549 --> 00:32:44,480 people so they would cut these friendly 739 00:32:50,630 --> 00:32:46,559 deals for their you know 740 00:32:54,070 --> 00:32:50,640 white dollar crime uh executives 741 00:32:56,789 --> 00:32:54,080 this is just terrible so you you were 742 00:32:58,230 --> 00:32:56,799 telling me a little bit about uh you 743 00:32:59,830 --> 00:32:58,240 know we've talked about these effects 744 00:33:02,310 --> 00:32:59,840 then there there's been 745 00:33:03,190 --> 00:33:02,320 because of this all these doctors are 746 00:33:05,029 --> 00:33:03,200 now 747 00:33:07,269 --> 00:33:05,039 somewhat terrified right to prescribe 748 00:33:09,909 --> 00:33:07,279 opioids right 749 00:33:12,149 --> 00:33:09,919 now they over the scale went way further 750 00:33:13,669 --> 00:33:12,159 the other way absolutely and what people 751 00:33:15,750 --> 00:33:13,679 are suffering because of that now 752 00:33:18,549 --> 00:33:15,760 because they can't get and they even if 753 00:33:21,269 --> 00:33:18,559 they have a valid need for a painkiller 754 00:33:23,509 --> 00:33:21,279 it's difficult to get now oh absolutely 755 00:33:25,110 --> 00:33:23,519 and that's one of the things and i was 756 00:33:27,830 --> 00:33:25,120 reporting on this 757 00:33:30,070 --> 00:33:27,840 i did some early research in 2018 and 758 00:33:31,830 --> 00:33:30,080 then i began publishing some articles 759 00:33:35,350 --> 00:33:31,840 when i finally got news organizations 760 00:33:36,870 --> 00:33:35,360 pay attention in 2019 761 00:33:40,149 --> 00:33:36,880 about the 762 00:33:41,110 --> 00:33:40,159 draconian impact and i interviewed 763 00:33:45,269 --> 00:33:41,120 um 764 00:33:47,750 --> 00:33:45,279 uh i interviewed the wife of a uh 765 00:33:50,230 --> 00:33:47,760 i interviewed the wife of 766 00:33:53,590 --> 00:33:50,240 jay lawrence who basically 767 00:33:55,909 --> 00:33:53,600 who committed suicide because a doctor 768 00:33:59,830 --> 00:33:55,919 even though he was an agonizing 769 00:34:01,830 --> 00:33:59,840 uh accident couldn't get access to 770 00:34:04,149 --> 00:34:01,840 legitimately prescribed opioids and was 771 00:34:05,029 --> 00:34:04,159 not a drug abuser and so what's happened 772 00:34:12,149 --> 00:34:05,039 is 773 00:34:15,430 --> 00:34:12,159 research on it and we'll be posting it 774 00:34:17,990 --> 00:34:15,440 is uh dr stefan cortez who's sort of the 775 00:34:20,389 --> 00:34:18,000 leading medical intellectual 776 00:34:21,990 --> 00:34:20,399 uh leading mental in electric medical 777 00:34:24,470 --> 00:34:22,000 intellectual in the field now and he has 778 00:34:27,829 --> 00:34:24,480 a new presentation that pulls it all 779 00:34:30,310 --> 00:34:27,839 together both how we went overboard in 780 00:34:32,149 --> 00:34:30,320 over medication early and how 781 00:34:34,470 --> 00:34:32,159 now we're going in the opposite 782 00:34:36,710 --> 00:34:34,480 direction with very serious 783 00:34:39,669 --> 00:34:36,720 damage and he has a study he's doing 784 00:34:42,790 --> 00:34:39,679 looking at suicide effects 785 00:34:45,109 --> 00:34:42,800 and recruiting family members to uh 786 00:34:47,589 --> 00:34:45,119 interview and that'll be available on 787 00:34:50,310 --> 00:34:47,599 his twitter feed but here's some of the 788 00:34:51,669 --> 00:34:50,320 things that have occurred is that it's 789 00:34:53,270 --> 00:34:51,679 been shown 790 00:34:55,510 --> 00:34:53,280 that 791 00:34:57,829 --> 00:34:55,520 this sudden sensation and this is 792 00:34:59,829 --> 00:34:57,839 according to a very recent study 793 00:35:02,550 --> 00:34:59,839 in the journal of uh 794 00:35:07,109 --> 00:35:02,560 general and internal medicine that 795 00:35:10,710 --> 00:35:07,119 sensation of legitimate prescribing has 796 00:35:12,630 --> 00:35:10,720 led to a three times greater risk of 797 00:35:15,270 --> 00:35:12,640 overdose deaths 798 00:35:17,750 --> 00:35:15,280 so the point is under the myth that if 799 00:35:20,950 --> 00:35:17,760 we just stop prescribing 800 00:35:23,750 --> 00:35:20,960 opioids for long-term chronic pain 801 00:35:26,310 --> 00:35:23,760 patients we're really helping them out 802 00:35:28,150 --> 00:35:26,320 and we are in fact it's going to be 803 00:35:29,990 --> 00:35:28,160 great for them because they're at lower 804 00:35:31,510 --> 00:35:30,000 risk of overdue no they're turning to 805 00:35:33,990 --> 00:35:31,520 street drugs or they're killing 806 00:35:36,870 --> 00:35:34,000 themselves and now 807 00:35:38,470 --> 00:35:36,880 the suicide data is really start 808 00:35:42,310 --> 00:35:38,480 starting to come in 809 00:35:44,950 --> 00:35:42,320 so there's a new study that came in 810 00:35:48,230 --> 00:35:44,960 uh on in oregon which is an example of a 811 00:35:50,870 --> 00:35:48,240 state that has extremely aggressive uh 812 00:35:53,109 --> 00:35:50,880 enforcement and cutbacks 813 00:35:56,470 --> 00:35:53,119 and so a new study has come out that 814 00:35:58,390 --> 00:35:56,480 shows and it just came out in april of 815 00:36:01,109 --> 00:35:58,400 this year 816 00:36:04,630 --> 00:36:01,119 and it showed that secession in oregon 817 00:36:06,390 --> 00:36:04,640 medicaid is associated with the three to 818 00:36:10,150 --> 00:36:06,400 five times 819 00:36:12,390 --> 00:36:10,160 greater risk of suicide that includes 820 00:36:14,870 --> 00:36:12,400 people actually killing themselves or 821 00:36:18,390 --> 00:36:14,880 having what's called suicidal ideation 822 00:36:20,870 --> 00:36:18,400 so up to five times more people 823 00:36:23,190 --> 00:36:20,880 are either killing themselves or in the 824 00:36:25,430 --> 00:36:23,200 throes of great depression and thinking 825 00:36:26,550 --> 00:36:25,440 seriously about it because they're being 826 00:36:29,109 --> 00:36:26,560 shut off 827 00:36:30,790 --> 00:36:29,119 and what's even more remarkable and this 828 00:36:32,310 --> 00:36:30,800 is kind of hard to believe because you 829 00:36:33,510 --> 00:36:32,320 wouldn't know about it at the state and 830 00:36:36,390 --> 00:36:33,520 local level 831 00:36:38,829 --> 00:36:36,400 most federal agencies 832 00:36:42,150 --> 00:36:38,839 starting in 2019 833 00:36:44,150 --> 00:36:42,160 through uh 2020 and some of this year 834 00:36:46,470 --> 00:36:44,160 that includes the fda 835 00:36:48,230 --> 00:36:46,480 the cdc 836 00:36:50,790 --> 00:36:48,240 hhs 837 00:36:52,710 --> 00:36:50,800 uh and also advisory 838 00:36:56,310 --> 00:36:52,720 groups like uh the american medical 839 00:36:59,829 --> 00:36:56,320 association have published papers saying 840 00:37:02,950 --> 00:36:59,839 we shouldn't be enforcing force tapering 841 00:37:05,910 --> 00:37:02,960 in a fast way for chronic pain patients 842 00:37:08,310 --> 00:37:05,920 who are stable so this is all the major 843 00:37:10,950 --> 00:37:08,320 organizations have said uh and a lot of 844 00:37:14,950 --> 00:37:10,960 it has to do with guidelines that came 845 00:37:17,349 --> 00:37:14,960 about in 2016 by the cbc which were 846 00:37:18,310 --> 00:37:17,359 informal recommendations 847 00:37:21,349 --> 00:37:18,320 for 848 00:37:24,230 --> 00:37:21,359 family physicians that they should try 849 00:37:27,190 --> 00:37:24,240 in initiating not go above what's called 850 00:37:30,870 --> 00:37:27,200 90 uh morphine 851 00:37:33,109 --> 00:37:30,880 mme morpheme milgram equivalent drugs 852 00:37:36,470 --> 00:37:33,119 but that was an advisory so what 853 00:37:39,829 --> 00:37:36,480 happened is that 90 mme figure 854 00:37:42,550 --> 00:37:39,839 advised in 2016 became a hard and fast 855 00:37:46,069 --> 00:37:42,560 rule across the country 856 00:37:49,430 --> 00:37:46,079 do not ever prescribe more than that for 857 00:37:51,030 --> 00:37:49,440 anyone no matter what their condition is 858 00:37:51,829 --> 00:37:51,040 what their genetic 859 00:37:55,910 --> 00:37:51,839 uh 860 00:37:58,470 --> 00:37:55,920 causing agony and there's about 200 861 00:38:00,470 --> 00:37:58,480 genetic conditions that have severe pain 862 00:38:01,190 --> 00:38:00,480 that merit appropriate 863 00:38:04,790 --> 00:38:01,200 uh 864 00:38:08,150 --> 00:38:04,800 a prescription so what's happened is 865 00:38:09,990 --> 00:38:08,160 this this informal advisory 866 00:38:12,630 --> 00:38:10,000 the cdc 867 00:38:15,910 --> 00:38:12,640 basically went on into the new england 868 00:38:19,109 --> 00:38:15,920 journal of medicine about 2 2020 869 00:38:21,829 --> 00:38:19,119 maybe 2019 saying hey folks uh you know 870 00:38:23,510 --> 00:38:21,839 our guidelines from 2016 they're kind of 871 00:38:25,670 --> 00:38:23,520 being misapplied and people are being 872 00:38:27,270 --> 00:38:25,680 hurt please don't do these forced 873 00:38:29,750 --> 00:38:27,280 taperings anymore 874 00:38:32,390 --> 00:38:29,760 that was totally ignored 875 00:38:34,390 --> 00:38:32,400 it got it some tension in the 876 00:38:37,430 --> 00:38:34,400 chronic pain advocacy community among 877 00:38:39,589 --> 00:38:37,440 researchers but in real life 878 00:38:40,790 --> 00:38:39,599 state health boards 879 00:38:43,589 --> 00:38:40,800 clinics 880 00:38:46,230 --> 00:38:43,599 in the state and localities insurance 881 00:38:49,190 --> 00:38:46,240 companies d.a 882 00:38:51,510 --> 00:38:49,200 everybody totally ignored it 883 00:38:53,270 --> 00:38:51,520 and and it's kind of crazy so the 884 00:38:56,470 --> 00:38:53,280 consensus 885 00:38:59,670 --> 00:38:56,480 medical opinion from experts is don't do 886 00:39:01,910 --> 00:38:59,680 drastic fast forced tapering of chronic 887 00:39:05,670 --> 00:39:01,920 pain patients particularly those who are 888 00:39:08,310 --> 00:39:05,680 stable and i've profiled people so for 889 00:39:12,550 --> 00:39:08,320 newsweek i did a story of a guy who was 890 00:39:14,950 --> 00:39:12,560 a really amazing he was an ex-marine 891 00:39:16,550 --> 00:39:14,960 who was an olympic contender 892 00:39:19,910 --> 00:39:16,560 and then he had an injury when he was a 893 00:39:21,750 --> 00:39:19,920 younger man a vet a veteran of vietnam 894 00:39:24,870 --> 00:39:21,760 war and other wars 895 00:39:27,270 --> 00:39:24,880 and and he was perfectly stable and had 896 00:39:29,670 --> 00:39:27,280 his own business and he was taking 897 00:39:32,470 --> 00:39:29,680 regular opioids as part of 898 00:39:35,270 --> 00:39:32,480 treatment for regular severe intractable 899 00:39:37,670 --> 00:39:35,280 pain and then they just cut him off and 900 00:39:42,710 --> 00:39:37,680 now he can't do anything he can't down 901 00:39:45,670 --> 00:39:42,720 hold a job and he is unable to even bend 902 00:39:47,190 --> 00:39:45,680 over and tie his own shoes so this guy 903 00:39:48,710 --> 00:39:47,200 used to be 904 00:39:51,589 --> 00:39:48,720 an incredible 905 00:39:55,190 --> 00:39:51,599 uh olympic level athlete can't tie his 906 00:39:57,510 --> 00:39:55,200 own shoes and if he wants to pat his own 907 00:40:00,470 --> 00:39:57,520 son young son on the head he can't reach 908 00:40:03,349 --> 00:40:00,480 over without being in agony now under 909 00:40:06,230 --> 00:40:03,359 what world is this considered rational 910 00:40:07,030 --> 00:40:06,240 it's not it's not yeah absolutely not 911 00:40:08,870 --> 00:40:07,040 yeah 912 00:40:11,270 --> 00:40:08,880 so they've gone a little too far the 913 00:40:13,829 --> 00:40:11,280 other way then and and sort of vilified 914 00:40:15,910 --> 00:40:13,839 the prescribing of opioids even right 915 00:40:18,150 --> 00:40:15,920 people really need them and it's it's 916 00:40:19,670 --> 00:40:18,160 easy to see how you know if you're like 917 00:40:21,270 --> 00:40:19,680 let's say you've been in chronic pain 918 00:40:23,190 --> 00:40:21,280 for three years and the doctors won't 919 00:40:24,309 --> 00:40:23,200 give you anything to help with it yeah 920 00:40:26,390 --> 00:40:24,319 you're going to get depressed and 921 00:40:27,270 --> 00:40:26,400 suicidal maybe living with that chronic 922 00:40:30,150 --> 00:40:27,280 pain 923 00:40:31,109 --> 00:40:30,160 and feeling hopeless you know 924 00:40:35,430 --> 00:40:31,119 so 925 00:40:37,430 --> 00:40:35,440 reduction because yeah 926 00:40:39,190 --> 00:40:37,440 i have personal experience with this but 927 00:40:41,430 --> 00:40:39,200 the one thing that i disagree with is 928 00:40:43,030 --> 00:40:41,440 safe injection sites because 929 00:40:44,150 --> 00:40:43,040 in the area in philadelphia i used to 930 00:40:47,349 --> 00:40:44,160 live it was 931 00:40:49,510 --> 00:40:47,359 there was just so many people affected 932 00:40:51,829 --> 00:40:49,520 by opiates and 933 00:40:53,190 --> 00:40:51,839 heroin addicts and and other things they 934 00:40:55,670 --> 00:40:53,200 decide they're going to do a safe 935 00:40:56,950 --> 00:40:55,680 injection site and then the number of 936 00:40:58,470 --> 00:40:56,960 the people 937 00:40:59,829 --> 00:40:58,480 you know that were sort of homeless 938 00:41:01,510 --> 00:40:59,839 hanging around 939 00:41:02,790 --> 00:41:01,520 that were addicted 940 00:41:04,230 --> 00:41:02,800 tripled 941 00:41:07,190 --> 00:41:04,240 in the area where they put the safe 942 00:41:09,670 --> 00:41:07,200 injection site where we're going to i 943 00:41:11,270 --> 00:41:09,680 would i would doubt that data the other 944 00:41:13,270 --> 00:41:11,280 what i'm getting at is the safe 945 00:41:16,150 --> 00:41:13,280 injection site is 946 00:41:18,230 --> 00:41:16,160 one wing of what's called harm reduction 947 00:41:21,270 --> 00:41:18,240 yeah let's get into it and explain 948 00:41:23,829 --> 00:41:21,280 what is this concept and basically 949 00:41:26,630 --> 00:41:23,839 the notion of harm reduction 950 00:41:29,510 --> 00:41:26,640 is several fold and 951 00:41:32,630 --> 00:41:29,520 uh basically the safe injection sites 952 00:41:35,990 --> 00:41:32,640 are sort of an outgrowth of what became 953 00:41:39,270 --> 00:41:36,000 the uh during the aids era the needle 954 00:41:41,589 --> 00:41:39,280 exchanges and for clean needles so 955 00:41:43,349 --> 00:41:41,599 intravenous drug users getting aids 956 00:41:46,470 --> 00:41:43,359 would not get aids okay that's the 957 00:41:50,150 --> 00:41:46,480 origin of this concept and this is again 958 00:41:52,550 --> 00:41:50,160 well chronicled in um mayas all of its 959 00:41:54,870 --> 00:41:52,560 uh new book which i recommend everyone 960 00:41:57,910 --> 00:41:54,880 to read but also 961 00:42:00,870 --> 00:41:57,920 so this is kind of an extension of that 962 00:42:03,589 --> 00:42:00,880 and part of the value is so i 963 00:42:05,750 --> 00:42:03,599 i would look closely when you hear oh 964 00:42:09,589 --> 00:42:05,760 where they opened up safe injection 965 00:42:12,230 --> 00:42:09,599 sites oh boy drug abuse tripled because 966 00:42:14,069 --> 00:42:12,240 of that's not the case yeah and i wasn't 967 00:42:16,550 --> 00:42:14,079 i wasn't citing any date it was my it 968 00:42:18,150 --> 00:42:16,560 was my personal observation that some 969 00:42:21,030 --> 00:42:18,160 areas seem to have 970 00:42:23,109 --> 00:42:21,040 much much more people there's this whole 971 00:42:25,589 --> 00:42:23,119 thing in philadelphia of like homeless 972 00:42:27,589 --> 00:42:25,599 camps of of people that right you know 973 00:42:29,589 --> 00:42:27,599 are affected by heroin and 974 00:42:31,589 --> 00:42:29,599 intense cities and things and it just 975 00:42:33,349 --> 00:42:31,599 seemed to me maybe it was just a regular 976 00:42:35,270 --> 00:42:33,359 increase you know 977 00:42:37,670 --> 00:42:35,280 because it just seemed to be in 978 00:42:39,829 --> 00:42:37,680 philadelphia it's like it's like the 979 00:42:42,790 --> 00:42:39,839 world's worst kept secret if you if you 980 00:42:45,349 --> 00:42:42,800 want to be addicted you just go to that 981 00:42:48,470 --> 00:42:45,359 area and the police don't the police 982 00:42:51,510 --> 00:42:48,480 leave them alone they don't well but my 983 00:42:53,829 --> 00:42:51,520 i guess my view is it's better to keep 984 00:42:55,589 --> 00:42:53,839 people alive than to throw them in jail 985 00:42:58,069 --> 00:42:55,599 and the other thing is 986 00:43:00,390 --> 00:42:58,079 there's a really other great book on the 987 00:43:02,069 --> 00:43:00,400 notion of decriminalization so in oregon 988 00:43:05,030 --> 00:43:02,079 there decriminals are 989 00:43:08,470 --> 00:43:05,040 possession of small amounts of anything 990 00:43:11,670 --> 00:43:08,480 including cocaine and heroin and 991 00:43:14,550 --> 00:43:11,680 and marijuana and so on and one of the 992 00:43:16,710 --> 00:43:14,560 things is we can look at the results in 993 00:43:17,910 --> 00:43:16,720 portugal which is in the book chasing 994 00:43:20,710 --> 00:43:17,920 the screen 995 00:43:23,430 --> 00:43:20,720 and he studied so this was a place that 996 00:43:25,349 --> 00:43:23,440 turned to really making harm reduction 997 00:43:27,589 --> 00:43:25,359 front and center 998 00:43:28,870 --> 00:43:27,599 of their thing what happened is when 999 00:43:32,309 --> 00:43:28,880 they made 1000 00:43:34,950 --> 00:43:32,319 it medically available 1001 00:43:37,670 --> 00:43:34,960 overdoses dropped significantly and they 1002 00:43:41,190 --> 00:43:37,680 didn't arrest people and so where we 1003 00:43:43,829 --> 00:43:41,200 have so i understand it may look like 1004 00:43:45,510 --> 00:43:43,839 what i'm getting at is there may be more 1005 00:43:46,790 --> 00:43:45,520 people in that area because they're 1006 00:43:49,349 --> 00:43:46,800 going 1007 00:43:51,510 --> 00:43:49,359 i don't think the fact 1008 00:43:54,150 --> 00:43:51,520 there's so many things that go into 1009 00:43:57,109 --> 00:43:54,160 turning someone into shooting drugs or 1010 00:43:58,870 --> 00:43:57,119 misusing drugs that the availability of 1011 00:44:01,750 --> 00:43:58,880 a safe outlet 1012 00:44:04,550 --> 00:44:01,760 after you become addicted is not a key 1013 00:44:07,270 --> 00:44:04,560 factor and that's a myth that's also 1014 00:44:09,829 --> 00:44:07,280 driving the how difficult it is in a lot 1015 00:44:11,829 --> 00:44:09,839 of places to get naloxone if i'm 1016 00:44:14,790 --> 00:44:11,839 pronouncing it correctly which is this 1017 00:44:17,270 --> 00:44:14,800 drug you can now get in many cities 1018 00:44:20,470 --> 00:44:17,280 uh over-the-counter without a 1019 00:44:24,230 --> 00:44:20,480 prescription and it is used to get 1020 00:44:26,950 --> 00:44:24,240 people to recover from overdoses 1021 00:44:28,870 --> 00:44:26,960 there's a long-acting version that shows 1022 00:44:31,190 --> 00:44:28,880 some effect efficacy 1023 00:44:33,510 --> 00:44:31,200 but it's but the short-acting version 1024 00:44:36,470 --> 00:44:33,520 should be i have one in my car 1025 00:44:39,270 --> 00:44:36,480 and my feeling is that anyone 1026 00:44:41,829 --> 00:44:39,280 who knows anyone who has an addiction 1027 00:44:45,190 --> 00:44:41,839 issue around an opioid should be 1028 00:44:47,829 --> 00:44:45,200 carrying this in their pocket and even 1029 00:44:51,109 --> 00:44:47,839 friends saves lives right it absolutely 1030 00:44:53,750 --> 00:44:51,119 saves lives and it recover 1031 00:44:56,630 --> 00:44:53,760 you know and it's unpleasant 1032 00:44:58,950 --> 00:44:56,640 to be revived from an overdose but it's 1033 00:45:01,030 --> 00:44:58,960 way better than living and 1034 00:45:03,190 --> 00:45:01,040 way better than dying yeah right and 1035 00:45:06,630 --> 00:45:03,200 it's way better than dying and now it's 1036 00:45:09,349 --> 00:45:06,640 own is now nasally available so this 1037 00:45:11,990 --> 00:45:09,359 kind of everybody remembers the pulp 1038 00:45:14,390 --> 00:45:12,000 fiction scene with uma thurman is on the 1039 00:45:16,790 --> 00:45:14,400 carpet and they revive her with the big 1040 00:45:18,470 --> 00:45:16,800 fat needles in the chest yes that's not 1041 00:45:21,510 --> 00:45:18,480 how it works today 1042 00:45:23,670 --> 00:45:21,520 it's a gentle nasal spray that can save 1043 00:45:24,390 --> 00:45:23,680 somebody's life and 1044 00:45:29,030 --> 00:45:24,400 mo 1045 00:45:32,870 --> 00:45:29,040 cops don't have it 1046 00:45:35,589 --> 00:45:32,880 most people don't have it and the upshot 1047 00:45:37,829 --> 00:45:35,599 of it is that it should be widely 1048 00:45:39,990 --> 00:45:37,839 available and can help prevent overdoses 1049 00:45:42,550 --> 00:45:40,000 but the where we really get into 1050 00:45:45,030 --> 00:45:42,560 overdose and addiction 1051 00:45:48,470 --> 00:45:45,040 dysfunction and addiction 1052 00:45:51,510 --> 00:45:48,480 is now described and again this has been 1053 00:45:55,109 --> 00:45:51,520 emphasized by mayas olivets and others 1054 00:45:57,109 --> 00:45:55,119 addiction is now described of compulsive 1055 00:45:59,910 --> 00:45:57,119 use of a substance 1056 00:46:01,430 --> 00:45:59,920 repeatedly in the face of harmful 1057 00:46:04,230 --> 00:46:01,440 consequences 1058 00:46:07,109 --> 00:46:04,240 as opposed to just using it in other 1059 00:46:08,470 --> 00:46:07,119 words so if you drink a drug if you 1060 00:46:14,069 --> 00:46:08,480 drink 1061 00:46:16,870 --> 00:46:14,079 liquor but you're not compulsively using 1062 00:46:19,670 --> 00:46:16,880 it and you're not losing your job your 1063 00:46:21,270 --> 00:46:19,680 wife your so on you're not really 1064 00:46:22,950 --> 00:46:21,280 addicted even if you're regularly 1065 00:46:25,670 --> 00:46:22,960 drinking but 1066 00:46:30,390 --> 00:46:25,680 so the point is this suboxone which is 1067 00:46:33,670 --> 00:46:30,400 the a variation of buprenephrine is so 1068 00:46:35,589 --> 00:46:33,680 underused in for so many reasons so 1069 00:46:37,190 --> 00:46:35,599 right now 1070 00:46:40,390 --> 00:46:37,200 two-thirds 1071 00:46:42,870 --> 00:46:40,400 of all treatment facilities in the u.s 1072 00:46:44,630 --> 00:46:42,880 don't make this medication assisted 1073 00:46:47,349 --> 00:46:44,640 treatment available 1074 00:46:49,109 --> 00:46:47,359 that is insane so i know i know at least 1075 00:46:50,870 --> 00:46:49,119 two people that got off of heroin with 1076 00:46:53,030 --> 00:46:50,880 suboxone 1077 00:46:53,829 --> 00:46:53,040 two you know and they and they and they 1078 00:46:58,950 --> 00:46:53,839 were 1079 00:47:01,829 --> 00:46:58,960 out of rehab for many years but once 1080 00:47:04,390 --> 00:47:01,839 they got the suboxone they were able to 1081 00:47:05,910 --> 00:47:04,400 to get off of the heroin completely can 1082 00:47:08,309 --> 00:47:05,920 you explain to us a little bit about 1083 00:47:09,430 --> 00:47:08,319 suboxone and what it is and how it works 1084 00:47:11,349 --> 00:47:09,440 yeah it's 1085 00:47:13,349 --> 00:47:11,359 a chemical that kind of 1086 00:47:16,309 --> 00:47:13,359 it it binds in some of the similar 1087 00:47:19,349 --> 00:47:16,319 places but it doesn't have the negative 1088 00:47:22,150 --> 00:47:19,359 effects and doesn't create a high so it 1089 00:47:24,710 --> 00:47:22,160 doesn't create the kind of compulsive 1090 00:47:27,030 --> 00:47:24,720 overuse that leads to addiction so it 1091 00:47:29,910 --> 00:47:27,040 can bind in similar areas of the brain 1092 00:47:33,670 --> 00:47:29,920 and makes it easier to stop using 1093 00:47:34,549 --> 00:47:33,680 the uh you know really dangerous opioids 1094 00:47:37,829 --> 00:47:34,559 uh 1095 00:47:41,430 --> 00:47:37,839 and but the point of it is is that 1096 00:47:43,990 --> 00:47:41,440 but one of the reasons it's so rare is 1097 00:47:46,950 --> 00:47:44,000 that we have 1098 00:47:49,430 --> 00:47:46,960 this crazy system for this really 1099 00:47:53,030 --> 00:47:49,440 effective drug so it'd be it would be 1100 00:47:55,190 --> 00:47:53,040 like if in the right now you have to get 1101 00:47:57,109 --> 00:47:55,200 these special x wavers even though 1102 00:47:59,670 --> 00:47:57,119 they've tinkered with it they're called 1103 00:48:02,069 --> 00:47:59,680 x wavers for doctors who want to treat 1104 00:48:04,470 --> 00:48:02,079 more than 30 people and if you treat 1105 00:48:06,790 --> 00:48:04,480 more than 30 people you're going to get 1106 00:48:09,589 --> 00:48:06,800 the attention of the dea 1107 00:48:12,549 --> 00:48:09,599 but these crazy little restrictions make 1108 00:48:14,950 --> 00:48:12,559 it very difficult for a lot of doctors 1109 00:48:17,270 --> 00:48:14,960 to uh prescribe it and there's no 1110 00:48:20,549 --> 00:48:17,280 incentive to prescribe it that's another 1111 00:48:22,150 --> 00:48:20,559 key thing it's sort of like if what 1112 00:48:24,230 --> 00:48:22,160 would have happened in the middle of the 1113 00:48:29,030 --> 00:48:24,240 polio epidemic 1114 00:48:31,670 --> 00:48:29,040 doctors had to fill out lots of 1115 00:48:35,990 --> 00:48:31,680 paperwork and sit through eight hours of 1116 00:48:38,710 --> 00:48:36,000 training on how to use the sabin or sog 1117 00:48:40,470 --> 00:48:38,720 vaccines okay yeah yeah that was 1118 00:48:42,309 --> 00:48:40,480 ridiculous if you have 1119 00:48:43,670 --> 00:48:42,319 a drug i don't understand if you have 1120 00:48:44,790 --> 00:48:43,680 this drug that is so incredibly 1121 00:48:48,390 --> 00:48:44,800 effective 1122 00:48:51,670 --> 00:48:48,400 why it's not more commonly used it's 1123 00:48:53,510 --> 00:48:51,680 it's part of a basically puritanical 1124 00:48:56,950 --> 00:48:53,520 punitive approach 1125 00:49:00,069 --> 00:48:56,960 that i think it's kind of reflective of 1126 00:49:01,990 --> 00:49:00,079 of a philosophy of government that i i i 1127 00:49:04,069 --> 00:49:02,000 think got to the height and trump 1128 00:49:07,670 --> 00:49:04,079 administration which is cruelty is the 1129 00:49:10,069 --> 00:49:07,680 point the belief is widespread in a lot 1130 00:49:11,829 --> 00:49:10,079 of even if you're that doesn't mean that 1131 00:49:14,390 --> 00:49:11,839 you're a right-winger necessarily the 1132 00:49:17,430 --> 00:49:14,400 concept is there's the belief that 1133 00:49:20,470 --> 00:49:17,440 drug users need to hit bottom and really 1134 00:49:21,990 --> 00:49:20,480 suffer and unless they suffer and suffer 1135 00:49:24,470 --> 00:49:22,000 and suffer and hit bottom they're not 1136 00:49:26,630 --> 00:49:24,480 going to change so the notion that 1137 00:49:28,950 --> 00:49:26,640 there's a way where they could safely 1138 00:49:31,910 --> 00:49:28,960 transition from their opioids to 1139 00:49:34,630 --> 00:49:31,920 something like bupinephrine and 1140 00:49:37,510 --> 00:49:34,640 produce in france it's been shown to 1141 00:49:39,109 --> 00:49:37,520 reduce overdoses 75 1142 00:49:40,549 --> 00:49:39,119 here it's 50 1143 00:49:44,870 --> 00:49:40,559 if you could cut 1144 00:49:48,390 --> 00:49:44,880 half of our you know uh you know 1145 00:49:49,270 --> 00:49:48,400 you know enormous overdose deaths uh you 1146 00:49:51,670 --> 00:49:49,280 know 1147 00:49:54,630 --> 00:49:51,680 with this medication it should be widely 1148 00:49:56,710 --> 00:49:54,640 used and it isn't and 1149 00:50:00,230 --> 00:49:56,720 i think it's part of a culture of 1150 00:50:02,790 --> 00:50:00,240 punishment and and and also i do think 1151 00:50:05,190 --> 00:50:02,800 it reflects a view 1152 00:50:06,870 --> 00:50:05,200 in the uh treating community the law 1153 00:50:08,230 --> 00:50:06,880 enforcement community and health 1154 00:50:10,549 --> 00:50:08,240 regulators 1155 00:50:12,390 --> 00:50:10,559 that you know people with substance 1156 00:50:15,829 --> 00:50:12,400 abuse are kind of 1157 00:50:18,630 --> 00:50:15,839 bad people or less than 1158 00:50:19,829 --> 00:50:18,640 human or evil now what but that has 1159 00:50:22,630 --> 00:50:19,839 changed 1160 00:50:25,349 --> 00:50:22,640 with the rise of the opioid epidemic and 1161 00:50:27,990 --> 00:50:25,359 there's a big reason it changed in terms 1162 00:50:30,950 --> 00:50:28,000 of more thought of compassion and need 1163 00:50:33,910 --> 00:50:30,960 for more treatment it's when white kids 1164 00:50:35,430 --> 00:50:33,920 began dying in droves 1165 00:50:39,750 --> 00:50:35,440 before 1166 00:50:41,270 --> 00:50:39,760 black people did it terrible black 1167 00:50:44,069 --> 00:50:41,280 people are doing heroin in the ghetto 1168 00:50:46,150 --> 00:50:44,079 who cares right right or once it reached 1169 00:50:48,390 --> 00:50:46,160 the sub i noticed once 1170 00:50:50,390 --> 00:50:48,400 once i started hearing from friends and 1171 00:50:52,069 --> 00:50:50,400 co-workers 1172 00:50:54,950 --> 00:50:52,079 that lived in the suburbs that their 1173 00:50:57,589 --> 00:50:54,960 children were going down into philly to 1174 00:50:59,829 --> 00:50:57,599 buy you know oxycontin pills or or 1175 00:51:01,750 --> 00:50:59,839 whatever percocets 1176 00:51:04,549 --> 00:51:01,760 then i started to notice 1177 00:51:06,309 --> 00:51:04,559 there was a marked change like you're 1178 00:51:08,309 --> 00:51:06,319 right we gotta do something about this 1179 00:51:10,069 --> 00:51:08,319 because now suddenly it's affecting 1180 00:51:11,670 --> 00:51:10,079 suburban white people 1181 00:51:13,910 --> 00:51:11,680 it's a shame but that's that's the 1182 00:51:16,870 --> 00:51:13,920 reality of part of that discrimination 1183 00:51:19,510 --> 00:51:16,880 was shown in the uh you know in the drug 1184 00:51:22,309 --> 00:51:19,520 enforcement laws which was 1185 00:51:25,750 --> 00:51:22,319 rock crack cocaine you got a much higher 1186 00:51:27,990 --> 00:51:25,760 sentence than if you use powder cocaine 1187 00:51:28,950 --> 00:51:28,000 yeah of course yeah and 1188 00:51:32,549 --> 00:51:28,960 and 1189 00:51:34,870 --> 00:51:32,559 this is you know 1190 00:51:36,870 --> 00:51:34,880 part of the absurdity of it 1191 00:51:39,549 --> 00:51:36,880 that but that's where 1192 00:51:42,470 --> 00:51:39,559 uh one of the there's something called 1193 00:51:44,069 --> 00:51:42,480 harmreduction.org and i'm also going to 1194 00:51:46,549 --> 00:51:44,079 be um 1195 00:51:47,990 --> 00:51:46,559 i'm also going to be uh 1196 00:51:49,990 --> 00:51:48,000 we're going to be putting in a resource 1197 00:51:52,549 --> 00:51:50,000 guide where people can look up some of 1198 00:51:53,910 --> 00:51:52,559 the latest research and findings on 1199 00:51:55,109 --> 00:51:53,920 these issues 1200 00:51:56,150 --> 00:51:55,119 um 1201 00:51:57,190 --> 00:51:56,160 and 1202 00:52:01,109 --> 00:51:57,200 so 1203 00:52:04,150 --> 00:52:01,119 here is that this 1204 00:52:09,030 --> 00:52:04,160 this is being so mismanaged 1205 00:52:10,470 --> 00:52:09,040 uh and i i am kind of shocked if we now 1206 00:52:12,309 --> 00:52:10,480 it really is hard to believe i was 1207 00:52:14,470 --> 00:52:12,319 reading in her 1208 00:52:18,069 --> 00:52:14,480 book in the opening section when we look 1209 00:52:21,030 --> 00:52:18,079 at all overdoses of all kinds and most 1210 00:52:23,510 --> 00:52:21,040 people who took 1211 00:52:25,510 --> 00:52:23,520 opioids are often taking other drugs 1212 00:52:27,670 --> 00:52:25,520 legally or illegally as well and so they 1213 00:52:29,750 --> 00:52:27,680 mix together but if you count all 1214 00:52:30,870 --> 00:52:29,760 opioids for all overdose from all 1215 00:52:34,630 --> 00:52:30,880 sources 1216 00:52:35,549 --> 00:52:34,640 nearly a million people have died 1217 00:52:39,030 --> 00:52:35,559 since 1218 00:52:40,390 --> 00:52:39,040 1999. it's cra it's so 1219 00:52:41,349 --> 00:52:40,400 crazy 1220 00:52:46,150 --> 00:52:41,359 and 1221 00:52:48,390 --> 00:52:46,160 old-fashioned policies to deal with the 1222 00:52:50,790 --> 00:52:48,400 modern health challenge 1223 00:52:51,670 --> 00:52:50,800 and and that's that's what we that's 1224 00:52:54,950 --> 00:52:51,680 what we 1225 00:52:58,069 --> 00:52:54,960 we need to take care of right now 1226 00:52:59,790 --> 00:52:58,079 uh in in in a fresh way 1227 00:53:01,670 --> 00:52:59,800 and i'm just sharing the website 1228 00:53:04,710 --> 00:53:01,680 harmreduction.org which is a good 1229 00:53:06,790 --> 00:53:04,720 resource uh you know from what i've seen 1230 00:53:09,510 --> 00:53:06,800 and and it seems like you know that they 1231 00:53:12,069 --> 00:53:09,520 really want to affect drug policy 1232 00:53:14,390 --> 00:53:12,079 to be pushed more to harm reduction and 1233 00:53:15,710 --> 00:53:14,400 i've always thought that you know i 1234 00:53:17,990 --> 00:53:15,720 don't know what i feel about drug 1235 00:53:20,150 --> 00:53:18,000 decriminalization but it's it's clear to 1236 00:53:21,430 --> 00:53:20,160 me that it's not a criminal issue it's a 1237 00:53:23,030 --> 00:53:21,440 health issue 1238 00:53:25,990 --> 00:53:23,040 and it should be treated more like a 1239 00:53:28,549 --> 00:53:26,000 health issue than a than a crime issue 1240 00:53:31,589 --> 00:53:28,559 well about a million people are arrested 1241 00:53:34,390 --> 00:53:31,599 a year so we have 2.3 million people 1242 00:53:37,349 --> 00:53:34,400 now the figures uh vary we have 2.3 1243 00:53:40,230 --> 00:53:37,359 million incarcerated right now in jails 1244 00:53:42,950 --> 00:53:40,240 and prisons a million people a year are 1245 00:53:46,270 --> 00:53:42,960 arrested locally for drug offenses now 1246 00:53:48,790 --> 00:53:46,280 the actual percentage of people in 1247 00:53:52,150 --> 00:53:48,800 incarceration now 1248 00:53:53,030 --> 00:53:52,160 that are charged directly with drugs is 1249 00:53:55,829 --> 00:53:53,040 20 1250 00:53:58,470 --> 00:53:55,839 but it's much higher a figure if you 1251 00:54:00,470 --> 00:53:58,480 count where where someone is committing 1252 00:54:02,870 --> 00:54:00,480 a crime or there's a shooting or there's 1253 00:54:04,230 --> 00:54:02,880 a turf rivalry or they're stealing and 1254 00:54:06,470 --> 00:54:04,240 they're not charged with the drug 1255 00:54:08,950 --> 00:54:06,480 offense so it's very significant and one 1256 00:54:12,150 --> 00:54:08,960 of the biggest places that is a cause of 1257 00:54:14,710 --> 00:54:12,160 death is people get incarcerated and 1258 00:54:16,549 --> 00:54:14,720 they're not given access to 1259 00:54:18,870 --> 00:54:16,559 they're giving they're made they're made 1260 00:54:21,109 --> 00:54:18,880 to go cold turkey off their drugs if 1261 00:54:23,990 --> 00:54:21,119 they're on it they're not given the 1262 00:54:25,829 --> 00:54:24,000 option of getting medicated assisted 1263 00:54:28,790 --> 00:54:25,839 medication-assisted treatment like uh 1264 00:54:31,910 --> 00:54:28,800 suboxone or other things either in jail 1265 00:54:34,870 --> 00:54:31,920 in most jails and certainly not when 1266 00:54:37,030 --> 00:54:34,880 they are discharged and and it's 1267 00:54:38,390 --> 00:54:37,040 considered i don't know how many times 1268 00:54:41,270 --> 00:54:38,400 higher but it's 1269 00:54:43,750 --> 00:54:41,280 hundreds of percent higher likelihood of 1270 00:54:46,549 --> 00:54:43,760 overdose and death 1271 00:54:48,150 --> 00:54:46,559 in the weeks following discharge from 1272 00:54:50,630 --> 00:54:48,160 jail okay 1273 00:54:52,950 --> 00:54:50,640 because there they've been cleaned out 1274 00:54:55,510 --> 00:54:52,960 sort of forced in and now they're quote 1275 00:54:58,150 --> 00:54:55,520 opioid naive they're lonely they're 1276 00:55:00,870 --> 00:54:58,160 depressed they can't find work they take 1277 00:55:02,630 --> 00:55:00,880 a drug and it's been out of their system 1278 00:55:05,750 --> 00:55:02,640 but they don't have any safer 1279 00:55:06,630 --> 00:55:05,760 alternatives and then they overdose so 1280 00:55:09,829 --> 00:55:06,640 yeah 1281 00:55:11,990 --> 00:55:09,839 it it it really like basically 1282 00:55:15,349 --> 00:55:12,000 this entire system 1283 00:55:16,789 --> 00:55:15,359 uh there's a there's a line from a a a 1284 00:55:19,030 --> 00:55:16,799 study uh 1285 00:55:21,750 --> 00:55:19,040 some decades ago about our educational 1286 00:55:24,309 --> 00:55:21,760 system and in it they said if our and 1287 00:55:26,230 --> 00:55:24,319 this applies to our entire drug system 1288 00:55:27,190 --> 00:55:26,240 and drug policy system 1289 00:55:29,190 --> 00:55:27,200 if 1290 00:55:31,910 --> 00:55:29,200 this drug and i'm paraphrasing this 1291 00:55:36,150 --> 00:55:31,920 reported education if our drug 1292 00:55:39,270 --> 00:55:36,160 system and drug policy was imposed on us 1293 00:55:41,910 --> 00:55:39,280 by a foreign country it would be viewed 1294 00:55:43,670 --> 00:55:41,920 as an act of war 1295 00:55:47,030 --> 00:55:43,680 and that's what this is it's like 1296 00:55:49,430 --> 00:55:47,040 literally there isn't one element of 1297 00:55:53,109 --> 00:55:49,440 commonly used procedures 1298 00:55:55,910 --> 00:55:53,119 or policy or enforcement or treatment 1299 00:55:58,549 --> 00:55:55,920 for addiction or handling of chronic 1300 00:56:00,870 --> 00:55:58,559 pain that is handled correctly so 1301 00:56:03,270 --> 00:56:00,880 naturally you're going to have increases 1302 00:56:05,430 --> 00:56:03,280 in suicide you're going to have 1303 00:56:06,710 --> 00:56:05,440 increases in overdoses 1304 00:56:08,390 --> 00:56:06,720 you'd think 1305 00:56:12,789 --> 00:56:08,400 if 90 1306 00:56:16,390 --> 00:56:12,799 94 000 people died of overdoses of all 1307 00:56:18,230 --> 00:56:16,400 kind in one year alone last year 1308 00:56:20,950 --> 00:56:18,240 obviously it was worsened by the 1309 00:56:22,630 --> 00:56:20,960 pandemic in many respects because of the 1310 00:56:25,190 --> 00:56:22,640 stress of being out of work the 1311 00:56:28,150 --> 00:56:25,200 loneliness and so on but you'd think 1312 00:56:31,030 --> 00:56:28,160 hello five alarm fire here 1313 00:56:32,870 --> 00:56:31,040 you know yeah yeah so i wanted to ask 1314 00:56:34,630 --> 00:56:32,880 you because i'm a little bit mis 1315 00:56:37,109 --> 00:56:34,640 i'm not very well informed about this 1316 00:56:39,349 --> 00:56:37,119 because i've had friends that were uh 1317 00:56:40,710 --> 00:56:39,359 opioid addicts so in one form or another 1318 00:56:42,470 --> 00:56:40,720 some of my 1319 00:56:43,670 --> 00:56:42,480 some people that i grew up with and knew 1320 00:56:45,030 --> 00:56:43,680 because you know because the 1321 00:56:46,950 --> 00:56:45,040 neighborhood that we grew up with it was 1322 00:56:49,190 --> 00:56:46,960 everywhere and there's lots of people 1323 00:56:51,670 --> 00:56:49,200 addicted to either 1324 00:56:54,950 --> 00:56:51,680 you know prescription pain kill pills 1325 00:56:58,150 --> 00:56:54,960 like like oxycontin or to actual going 1326 00:56:59,990 --> 00:56:58,160 to heroin and shooting heroin so several 1327 00:57:02,789 --> 00:57:00,000 people i know have gotten off of heroin 1328 00:57:04,549 --> 00:57:02,799 with suboxone but others have gone to a 1329 00:57:06,470 --> 00:57:04,559 methadone clinic and that kind of 1330 00:57:08,789 --> 00:57:06,480 treatment program can you talk about the 1331 00:57:11,349 --> 00:57:08,799 effectiveness of the methadone 1332 00:57:13,510 --> 00:57:11,359 method and what is methadone and how 1333 00:57:15,750 --> 00:57:13,520 does it work and what you know i don't 1334 00:57:18,630 --> 00:57:15,760 know the methadone has been around much 1335 00:57:21,670 --> 00:57:18,640 longer it the issue with methadone is 1336 00:57:25,910 --> 00:57:21,680 this it's really effective if it is 1337 00:57:27,589 --> 00:57:25,920 titrated up correctly and personalized 1338 00:57:29,829 --> 00:57:27,599 in other words 1339 00:57:32,789 --> 00:57:29,839 the the the reason that suboxone is 1340 00:57:35,430 --> 00:57:32,799 taken off in terms of interest is it has 1341 00:57:38,789 --> 00:57:35,440 a safer it's a it's a better safety 1342 00:57:46,950 --> 00:57:38,799 profile and you can use it at home 1343 00:57:51,430 --> 00:57:49,430 and you're monitored in these sort of 1344 00:57:54,630 --> 00:57:51,440 horrific you know 1345 00:57:57,030 --> 00:57:54,640 cinder block locations you know go into 1346 00:57:59,349 --> 00:57:57,040 terrible neighborhoods and stand in line 1347 00:58:02,309 --> 00:57:59,359 and get it i mean but on the other hand 1348 00:58:04,230 --> 00:58:02,319 it it has a very good track record the 1349 00:58:07,829 --> 00:58:04,240 difficulty is 1350 00:58:10,069 --> 00:58:07,839 that uh and there is there have been if 1351 00:58:15,030 --> 00:58:10,079 people are 1352 00:58:17,750 --> 00:58:15,040 carefully for what their where their 1353 00:58:20,630 --> 00:58:17,760 opioid levels are at when they start 1354 00:58:24,630 --> 00:58:20,640 method on treatment there is risks that 1355 00:58:27,589 --> 00:58:24,640 they may uh face on the other hand it's 1356 00:58:29,589 --> 00:58:27,599 been very very beneficial 1357 00:58:32,470 --> 00:58:29,599 it's an older form of treatment but it 1358 00:58:35,589 --> 00:58:32,480 is extremely beneficial 1359 00:58:37,990 --> 00:58:35,599 um and what is it what is methadone sort 1360 00:58:40,390 --> 00:58:38,000 of a replacement for an opiate and then 1361 00:58:44,390 --> 00:58:40,400 they slowly wean you off they give you 1362 00:58:51,270 --> 00:58:47,990 it it it i'm not i'm it binds it it 1363 00:58:58,390 --> 00:58:54,870 it is an alternative to really dangerous 1364 00:59:00,870 --> 00:58:58,400 opioids that create uh 1365 00:59:02,789 --> 00:59:00,880 a need for upping and upping the dosage 1366 00:59:04,870 --> 00:59:02,799 so when they get the right dosage for 1367 00:59:07,829 --> 00:59:04,880 methadone you 1368 00:59:10,230 --> 00:59:07,839 you get the drug but you can have a 1369 00:59:14,549 --> 00:59:10,240 family life you can hold down a job and 1370 00:59:15,349 --> 00:59:14,559 so on uh so i'm just saying that it's 1371 00:59:16,470 --> 00:59:15,359 it's 1372 00:59:19,349 --> 00:59:16,480 worth 1373 00:59:20,390 --> 00:59:19,359 already 1374 00:59:22,870 --> 00:59:20,400 using 1375 00:59:25,430 --> 00:59:22,880 um addictive drugs now what actually is 1376 00:59:27,670 --> 00:59:25,440 also happening the shortage of the 1377 00:59:30,230 --> 00:59:27,680 ability to get suboxone has led to a 1378 00:59:31,750 --> 00:59:30,240 street trade and suboxone 1379 00:59:32,789 --> 00:59:31,760 your people in the live chat are 1380 00:59:34,710 --> 00:59:32,799 mentioned there's some people in the 1381 00:59:37,750 --> 00:59:34,720 live chat who mention that they buy 1382 00:59:41,430 --> 00:59:37,760 suboxone on the street now that's the 1383 00:59:45,190 --> 00:59:41,440 like it like this is this is how crazy 1384 00:59:47,430 --> 00:59:45,200 things are a lot of people now are or 1385 00:59:49,510 --> 00:59:47,440 buy are buying it and it's sold on the 1386 00:59:52,230 --> 00:59:49,520 street and you have to pray to god that 1387 00:59:54,549 --> 00:59:52,240 it is in fact really suboxone and one of 1388 00:59:57,829 --> 00:59:54,559 the things about street drugs is that 1389 01:00:00,069 --> 00:59:57,839 whenever you buy something on the street 1390 01:00:02,069 --> 01:00:00,079 it could be laced with fentanyl 1391 01:00:04,549 --> 01:00:02,079 illegally imported and 1392 01:00:06,710 --> 01:00:04,559 made to look like a counterfeit pill you 1393 01:00:08,630 --> 01:00:06,720 have no idea whether it's labeled 1394 01:00:12,150 --> 01:00:08,640 correctly what it is 1395 01:00:14,789 --> 01:00:12,160 and that even applies to suboxone and 1396 01:00:17,990 --> 01:00:14,799 it's it's a sign now i don't know 1397 01:00:21,109 --> 01:00:18,000 whether this is true or not basically 1398 01:00:23,910 --> 01:00:21,119 people who could be in medically uh 1399 01:00:27,109 --> 01:00:23,920 monitored suboxone treatment are 1400 01:00:28,470 --> 01:00:27,119 basically taking suboxone they buy on 1401 01:00:31,510 --> 01:00:28,480 the street 1402 01:00:35,190 --> 01:00:31,520 to allow them to 1403 01:00:37,510 --> 01:00:35,200 uh manage uh over you know a 1404 01:00:41,190 --> 01:00:37,520 cold turkey in between getting their 1405 01:00:45,270 --> 01:00:41,200 next opioid hit or shot either pills or 1406 01:00:47,270 --> 01:00:45,280 shot and so they take street suboxone to 1407 01:00:49,670 --> 01:00:47,280 allow them to weather 1408 01:00:51,670 --> 01:00:49,680 the chills and oh and withdrawal yeah 1409 01:00:53,349 --> 01:00:51,680 the withdrawal symptoms they're taking 1410 01:00:54,710 --> 01:00:53,359 it just to manage the withdrawal center 1411 01:00:57,990 --> 01:00:54,720 but the fact that they have to get it on 1412 01:00:59,109 --> 01:00:58,000 the street is crazy it's crazy it should 1413 01:01:01,349 --> 01:00:59,119 not be 1414 01:01:03,829 --> 01:01:01,359 like this yeah i mean if it was up to me 1415 01:01:05,750 --> 01:01:03,839 especially especially near where i grew 1416 01:01:07,270 --> 01:01:05,760 up which is kensington philadelphia i 1417 01:01:09,270 --> 01:01:07,280 mean there's all these tent cities with 1418 01:01:12,150 --> 01:01:09,280 all these people on heroin they should 1419 01:01:14,309 --> 01:01:12,160 be down there handing out suboxone 1420 01:01:16,549 --> 01:01:14,319 to all those people yeah they should 1421 01:01:18,950 --> 01:01:16,559 have access to that the other thing 1422 01:01:21,270 --> 01:01:18,960 about it is 1423 01:01:23,349 --> 01:01:21,280 i don't know the long the long term 1424 01:01:25,430 --> 01:01:23,359 safety profile is fantastic but if 1425 01:01:27,910 --> 01:01:25,440 you're in a medical setting 1426 01:01:30,150 --> 01:01:27,920 you have a reasonable chance 1427 01:01:32,309 --> 01:01:30,160 of getting 1428 01:01:35,349 --> 01:01:32,319 into other kinds of treatment to deal 1429 01:01:38,789 --> 01:01:35,359 with the underlying psychological issues 1430 01:01:41,109 --> 01:01:38,799 that helped bring about the addiction in 1431 01:01:43,829 --> 01:01:41,119 the first place but one of the points 1432 01:01:45,589 --> 01:01:43,839 that is i highlight and by the way one 1433 01:01:47,589 --> 01:01:45,599 of the people listening is the excellent 1434 01:01:50,150 --> 01:01:47,599 stefan cortez 1435 01:01:52,789 --> 01:01:50,160 check his thing his twitter feed at 1436 01:01:54,309 --> 01:01:52,799 stefan cortez he's basically the best 1437 01:01:57,109 --> 01:01:54,319 informed guy 1438 01:01:58,069 --> 01:01:57,119 out there about the range of issues him 1439 01:02:00,549 --> 01:01:58,079 and 1440 01:02:03,029 --> 01:02:00,559 at maya s z 1441 01:02:05,589 --> 01:02:03,039 if you just follow those two people 1442 01:02:06,470 --> 01:02:05,599 and then kate nicholson speaking about 1443 01:02:08,549 --> 01:02:06,480 pain 1444 01:02:10,630 --> 01:02:08,559 uh those three you follow those three 1445 01:02:15,430 --> 01:02:10,640 you'll be really informed on both harm 1446 01:02:18,470 --> 01:02:15,440 reduction and what is at stake in the um 1447 01:02:20,470 --> 01:02:18,480 in terms of the chronic pain community 1448 01:02:21,829 --> 01:02:20,480 and they're we thank we thank them for 1449 01:02:23,589 --> 01:02:21,839 the work that they do because this is 1450 01:02:25,349 --> 01:02:23,599 important work and people need to be 1451 01:02:27,829 --> 01:02:25,359 educated on these issues yeah and 1452 01:02:29,430 --> 01:02:27,839 they're basically and that's where i uh 1453 01:02:31,029 --> 01:02:29,440 in my resource guide that we'll be 1454 01:02:32,950 --> 01:02:31,039 posting later i refer to something 1455 01:02:34,870 --> 01:02:32,960 called changing the narrative 1456 01:02:39,990 --> 01:02:34,880 where it is 1457 01:02:43,990 --> 01:02:40,000 there's so much disinformation and 1458 01:02:46,390 --> 01:02:44,000 stigmatizing language and all of that 1459 01:02:49,029 --> 01:02:46,400 uh that that 1460 01:02:51,589 --> 01:02:49,039 we were just a lot of a lot of 1461 01:02:52,950 --> 01:02:51,599 misinformation and disinformation 1462 01:02:55,750 --> 01:02:52,960 and 1463 01:02:59,190 --> 01:02:55,760 so one of the things is almost anything 1464 01:03:01,710 --> 01:02:59,200 that you hear about from most doctors 1465 01:03:04,069 --> 01:03:01,720 and treatment facilities who are 1466 01:03:06,789 --> 01:03:04,079 overwhelmingly opposed to using 1467 01:03:09,510 --> 01:03:06,799 medicated assisted treatment for opioids 1468 01:03:12,309 --> 01:03:09,520 i mean basically the government like the 1469 01:03:15,349 --> 01:03:12,319 12-step programs can be very valuable as 1470 01:03:18,390 --> 01:03:15,359 an adjunct to other things but if you 1471 01:03:21,430 --> 01:03:18,400 you shouldn't be in a program where the 1472 01:03:24,630 --> 01:03:21,440 sole method of dealing with your 1473 01:03:26,950 --> 01:03:24,640 addiction is to sit in a 12-step program 1474 01:03:29,029 --> 01:03:26,960 that you could do for free at a nearby 1475 01:03:31,589 --> 01:03:29,039 church yeah and isn't it medically 1476 01:03:33,990 --> 01:03:31,599 dangerous for people to just go because 1477 01:03:35,510 --> 01:03:34,000 i had a fr i have one friend who quit 1478 01:03:38,150 --> 01:03:35,520 heroin he 1479 01:03:40,630 --> 01:03:38,160 he hit rock bottom he lost his family 1480 01:03:42,870 --> 01:03:40,640 his children and then one day he woke up 1481 01:03:45,109 --> 01:03:42,880 and he said i'm kicking heroin and he 1482 01:03:47,190 --> 01:03:45,119 kicked heroin cold turkey he was a 1483 01:03:49,430 --> 01:03:47,200 heroin user for five years 1484 01:03:51,990 --> 01:03:49,440 and he thought he was gonna die he ended 1485 01:03:53,589 --> 01:03:52,000 up walking himself to the hospital a 1486 01:03:55,589 --> 01:03:53,599 nearby hospital 1487 01:03:57,430 --> 01:03:55,599 and uh they didn't give him any form of 1488 01:03:59,990 --> 01:03:57,440 treatment they just sort of uh you know 1489 01:04:01,589 --> 01:04:00,000 gave him an iv and tried to get talked 1490 01:04:03,190 --> 01:04:01,599 to him about getting counseling for his 1491 01:04:05,109 --> 01:04:03,200 drug addiction but they didn't give him 1492 01:04:07,349 --> 01:04:05,119 any medical assistance and it seems to 1493 01:04:09,029 --> 01:04:07,359 me to be very cruel because when 1494 01:04:10,950 --> 01:04:09,039 somebody is kicking heroin you know 1495 01:04:12,630 --> 01:04:10,960 they're throwing up their bones hurt 1496 01:04:15,190 --> 01:04:12,640 right they're having all these body 1497 01:04:16,950 --> 01:04:15,200 aches they're in terrible terrible pain 1498 01:04:19,589 --> 01:04:16,960 there's got to be 1499 01:04:22,630 --> 01:04:19,599 some medical interventions 1500 01:04:26,390 --> 01:04:22,640 but it's not used and there is 1501 01:04:28,950 --> 01:04:26,400 my feeling i i have a i have a two 1502 01:04:31,589 --> 01:04:28,960 i have my my big simple solution for all 1503 01:04:32,390 --> 01:04:31,599 our nation's drug policies 1504 01:04:35,510 --> 01:04:32,400 is 1505 01:04:38,710 --> 01:04:35,520 have as co-directing drug czars of the 1506 01:04:41,349 --> 01:04:38,720 country myus is olivet the author and 1507 01:04:43,910 --> 01:04:41,359 researcher stefan cortez and have them 1508 01:04:45,750 --> 01:04:43,920 set national drug policy and then 1509 01:04:47,109 --> 01:04:45,760 everybody follow what they say but 1510 01:04:49,430 --> 01:04:47,119 that's not going to happen 1511 01:04:51,990 --> 01:04:49,440 but in a world of f 1512 01:04:53,349 --> 01:04:52,000 in a world of um 1513 01:04:55,750 --> 01:04:53,359 of uh 1514 01:04:59,990 --> 01:04:55,760 philosophical philosopher kings that 1515 01:05:02,789 --> 01:05:00,000 would happen now lord ludacris played uh 1516 01:05:05,349 --> 01:05:02,799 uh is uh plaid has mentioned that he's 1517 01:05:07,029 --> 01:05:05,359 someone who's in favor of long-term 1518 01:05:09,910 --> 01:05:07,039 suboxone use so 1519 01:05:12,950 --> 01:05:09,920 maybe he can comment or he can ask a 1520 01:05:16,069 --> 01:05:12,960 question or so on he seems to be someone 1521 01:05:18,549 --> 01:05:16,079 yeah virtual experience so um you know 1522 01:05:20,309 --> 01:05:18,559 it's it's interesting that you know and 1523 01:05:22,789 --> 01:05:20,319 and of course i'm not saying this in a 1524 01:05:25,349 --> 01:05:22,799 derogatory way but i had no idea how 1525 01:05:28,069 --> 01:05:25,359 many of my viewers and listeners have 1526 01:05:30,470 --> 01:05:28,079 been affected by opiates a lot of these 1527 01:05:32,630 --> 01:05:30,480 people are long-term listeners and right 1528 01:05:34,470 --> 01:05:32,640 i'm hearing their stories about 1529 01:05:35,750 --> 01:05:34,480 their one-time addiction and how they 1530 01:05:38,309 --> 01:05:35,760 treat their addiction through either 1531 01:05:40,630 --> 01:05:38,319 suboxone or or uh you know other 1532 01:05:42,309 --> 01:05:40,640 treatments and you know 1533 01:05:43,910 --> 01:05:42,319 that's how many people are affected that 1534 01:05:45,510 --> 01:05:43,920 we've got all these people in my 1535 01:05:47,430 --> 01:05:45,520 audience i didn't even know that had 1536 01:05:49,349 --> 01:05:47,440 issues in the past you know because it's 1537 01:05:50,789 --> 01:05:49,359 not it's not a common thing that people 1538 01:05:52,390 --> 01:05:50,799 bring up but since we're talking about 1539 01:05:55,990 --> 01:05:52,400 on the show tonight people are sharing 1540 01:05:56,870 --> 01:05:56,000 their personal stories which is great 1541 01:05:59,589 --> 01:05:56,880 yeah 1542 01:06:00,870 --> 01:05:59,599 and and and and it is still 1543 01:06:02,390 --> 01:06:00,880 shocking 1544 01:06:06,309 --> 01:06:02,400 to me that 1545 01:06:09,029 --> 01:06:06,319 these uh reasonable uh policies are not 1546 01:06:10,950 --> 01:06:09,039 widely used and i 1547 01:06:13,109 --> 01:06:10,960 so i'm not sure 1548 01:06:15,029 --> 01:06:13,119 that's one of the things that's really 1549 01:06:16,390 --> 01:06:15,039 tragic about the health care system 1550 01:06:20,069 --> 01:06:16,400 years ago 1551 01:06:23,109 --> 01:06:20,079 there was a very a general look at 1552 01:06:24,789 --> 01:06:23,119 how does evidence-based approaches to 1553 01:06:26,470 --> 01:06:24,799 any medical thing about the best 1554 01:06:27,589 --> 01:06:26,480 approach to deal with 1555 01:06:29,990 --> 01:06:27,599 um 1556 01:06:32,789 --> 01:06:30,000 surgery or best approach to deal with 1557 01:06:34,150 --> 01:06:32,799 heart attacks unfortunately according to 1558 01:06:35,270 --> 01:06:34,160 gao 1559 01:06:40,470 --> 01:06:35,280 and 1560 01:06:44,549 --> 01:06:40,480 academy sciences there's usually a 30 1561 01:06:46,470 --> 01:06:44,559 year gap between what is in 1562 01:06:49,750 --> 01:06:46,480 the medical literature 1563 01:06:51,270 --> 01:06:49,760 about what work for any medical or 1564 01:06:53,990 --> 01:06:51,280 addiction issue 1565 01:06:58,230 --> 01:06:54,000 and when it's widely intimate well we 1566 01:07:00,630 --> 01:06:58,240 can't have a 30-year gap 1567 01:07:03,670 --> 01:07:00,640 doing the before we do the right thing 1568 01:07:06,390 --> 01:07:03,680 if ninety thousand four thousand people 1569 01:07:09,829 --> 01:07:06,400 or a year are dying of 1570 01:07:11,270 --> 01:07:09,839 drug overdoses okay yeah yeah absolutely 1571 01:07:13,190 --> 01:07:11,280 we have that 1572 01:07:14,950 --> 01:07:13,200 you can't have that i can't just let 1573 01:07:16,549 --> 01:07:14,960 everybody suffer for 30 years while the 1574 01:07:18,789 --> 01:07:16,559 medical industry and the doctors catch 1575 01:07:21,029 --> 01:07:18,799 up and isn't a part of the problem too 1576 01:07:22,549 --> 01:07:21,039 and you know not to take it listen 1577 01:07:29,670 --> 01:07:22,559 doctors are i've known some great 1578 01:07:32,549 --> 01:07:31,349 so uh 1579 01:07:35,510 --> 01:07:32,559 you know 1580 01:07:37,270 --> 01:07:35,520 go forward and learn what the best 1581 01:07:39,029 --> 01:07:37,280 current treatments are they just 1582 01:07:39,910 --> 01:07:39,039 remember what they knew from medical 1583 01:07:41,670 --> 01:07:39,920 school 1584 01:07:44,470 --> 01:07:41,680 which could yeah so one of the key 1585 01:07:47,750 --> 01:07:44,480 points that dr cortez makes 1586 01:07:49,109 --> 01:07:47,760 is the lack of training it's just crazy 1587 01:07:50,910 --> 01:07:49,119 we've been in 1588 01:07:53,670 --> 01:07:50,920 for since 1589 01:07:56,390 --> 01:07:53,680 1999 we've had a massive 1590 01:07:58,069 --> 01:07:56,400 opioid crisis and we've i had a 1591 01:07:59,109 --> 01:07:58,079 concomitant 1592 01:08:01,270 --> 01:07:59,119 um 1593 01:08:04,710 --> 01:08:01,280 collateral damage of chronic pain 1594 01:08:07,750 --> 01:08:04,720 patients suffering from extreme sharp 1595 01:08:10,470 --> 01:08:07,760 withdrawals that are preventable 1596 01:08:13,589 --> 01:08:10,480 there's so little training on either 1597 01:08:16,229 --> 01:08:13,599 addiction treatment or dealing with 1598 01:08:18,789 --> 01:08:16,239 law chronic pain or pain management in a 1599 01:08:21,910 --> 01:08:18,799 responsible way in medical schools so 1600 01:08:24,630 --> 01:08:21,920 though they come out totally ignorant 1601 01:08:25,990 --> 01:08:24,640 and then they just pick up folklore 1602 01:08:29,590 --> 01:08:26,000 in other words 1603 01:08:33,269 --> 01:08:29,600 now the different so right now 1604 01:08:36,829 --> 01:08:33,279 actual prescribed actual doctors learn 1605 01:08:40,149 --> 01:08:36,839 what they learn from two sources 1606 01:08:45,030 --> 01:08:40,159 folklore with often erroneous word of 1607 01:08:48,709 --> 01:08:45,040 mouth and whatever the drug industry 1608 01:08:51,189 --> 01:08:48,719 sales rep is doing them okay 1609 01:08:53,669 --> 01:08:51,199 and uh i'm friendly with some of the 1610 01:08:56,149 --> 01:08:53,679 people listening are are part of the 1611 01:08:58,630 --> 01:08:56,159 very uh sophisticated chronic pain 1612 01:09:00,789 --> 01:08:58,640 advocacy community like galena uh 1613 01:09:02,390 --> 01:09:00,799 peacock yeah thank you for your thank 1614 01:09:05,269 --> 01:09:02,400 you for your work it's much needed and 1615 01:09:08,149 --> 01:09:05,279 appreciated really knows a lot i've 1616 01:09:09,990 --> 01:09:08,159 quoted her in articles and and yes and 1617 01:09:13,349 --> 01:09:10,000 there she just mentioned the issue of 1618 01:09:16,470 --> 01:09:13,359 stigma so basically it is still 1619 01:09:18,630 --> 01:09:16,480 it's less so because so many celebrities 1620 01:09:20,709 --> 01:09:18,640 have ended up um 1621 01:09:23,269 --> 01:09:20,719 have ended up dying 1622 01:09:25,669 --> 01:09:23,279 uh that from overdoses that we're more 1623 01:09:26,789 --> 01:09:25,679 aware of it but there's still this 1624 01:09:28,789 --> 01:09:26,799 stigma 1625 01:09:31,910 --> 01:09:28,799 and uh this is a 1626 01:09:34,630 --> 01:09:31,920 i i this is a kind of bizarre idea but i 1627 01:09:37,110 --> 01:09:34,640 kind of wish i'm a huge music lover i 1628 01:09:40,630 --> 01:09:37,120 kind of wish we could go back in time 1629 01:09:41,910 --> 01:09:40,640 and save jimi hendrix janice joplin 1630 01:09:45,030 --> 01:09:41,920 brian 1631 01:09:46,229 --> 01:09:45,040 jones has so many effects yeah all these 1632 01:09:47,110 --> 01:09:46,239 amazing 1633 01:09:49,430 --> 01:09:47,120 great 1634 01:09:50,789 --> 01:09:49,440 jim morrison as well jim morrison all of 1635 01:09:52,950 --> 01:09:50,799 these people 1636 01:09:55,030 --> 01:09:52,960 from if they had access to really 1637 01:09:57,030 --> 01:09:55,040 effective care and treatment that is one 1638 01:10:01,030 --> 01:09:57,040 of and so one of the things that i've 1639 01:10:02,870 --> 01:10:01,040 posted is a really smart i uh one i 1640 01:10:05,030 --> 01:10:02,880 posted some information there's a book 1641 01:10:06,470 --> 01:10:05,040 by ann fletcher that i think anyone with 1642 01:10:09,510 --> 01:10:06,480 addiction or family member with 1643 01:10:10,630 --> 01:10:09,520 addiction should read it's called inside 1644 01:10:12,709 --> 01:10:10,640 rehab 1645 01:10:15,110 --> 01:10:12,719 and it's by ann fletcher but i've also 1646 01:10:17,350 --> 01:10:15,120 posted articles by maya 1647 01:10:18,229 --> 01:10:17,360 and i am also 1648 01:10:21,430 --> 01:10:18,239 um 1649 01:10:22,550 --> 01:10:21,440 i am also uh posting stuff from the harm 1650 01:10:26,149 --> 01:10:22,560 reduction 1651 01:10:30,310 --> 01:10:26,159 uh coalition and the uh kate nicholson's 1652 01:10:31,990 --> 01:10:30,320 national pain advocacy center and all of 1653 01:10:33,590 --> 01:10:32,000 we've got these resources in the about 1654 01:10:34,870 --> 01:10:33,600 section i wasn't able to fit them all so 1655 01:10:37,510 --> 01:10:34,880 we're going to be editing it after the 1656 01:10:39,590 --> 01:10:37,520 show again and get them all in like i 1657 01:10:42,229 --> 01:10:39,600 said mr levine gave me this treasure 1658 01:10:44,550 --> 01:10:42,239 trove of resources for people that's so 1659 01:10:46,470 --> 01:10:44,560 so data rich and there's so much that i 1660 01:10:48,709 --> 01:10:46,480 i have trouble fitting it all in before 1661 01:10:50,149 --> 01:10:48,719 broadcast time but we will be editing it 1662 01:10:52,870 --> 01:10:50,159 so that all those resources will be 1663 01:10:55,270 --> 01:10:52,880 available for anybody's bad things 1664 01:10:59,110 --> 01:10:55,280 when i was reading maya's book 1665 01:11:01,910 --> 01:10:59,120 uh she does interviews with family 1666 01:11:04,310 --> 01:11:01,920 mothers of people who died of drug 1667 01:11:07,110 --> 01:11:04,320 overdoses and neither they 1668 01:11:09,990 --> 01:11:07,120 nor their children knew anything about 1669 01:11:13,110 --> 01:11:10,000 naloxone which could 1670 01:11:14,470 --> 01:11:13,120 revive people from overdoses 1671 01:11:17,669 --> 01:11:14,480 nothing 1672 01:11:18,630 --> 01:11:17,679 thing 1673 01:11:20,790 --> 01:11:18,640 and 1674 01:11:24,229 --> 01:11:20,800 it it's just 1675 01:11:26,790 --> 01:11:24,239 i i li i am kind of at a loss 1676 01:11:29,669 --> 01:11:26,800 because because i follow a lot of 1677 01:11:32,030 --> 01:11:29,679 bad developments in public policy 1678 01:11:34,630 --> 01:11:32,040 uh you know in terms of 1679 01:11:36,630 --> 01:11:34,640 authoritarianism and bad 1680 01:11:40,630 --> 01:11:36,640 developments and voting 1681 01:11:43,750 --> 01:11:40,640 i don't have a simple explanation for 1682 01:11:46,229 --> 01:11:43,760 why every single element of anything to 1683 01:11:48,790 --> 01:11:46,239 do with drugs in our country is always 1684 01:11:51,110 --> 01:11:48,800 the wrong thing but that's sort of where 1685 01:11:52,790 --> 01:11:51,120 we're at 1686 01:11:54,790 --> 01:11:52,800 we have an excellent question here that 1687 01:11:55,669 --> 01:11:54,800 it's actually on my list 1688 01:11:57,510 --> 01:11:55,679 uh 1689 01:11:59,590 --> 01:11:57,520 mr levine what are your suggestions 1690 01:12:01,590 --> 01:11:59,600 these days for a path for chronic pain 1691 01:12:05,110 --> 01:12:01,600 it appears there are a few roots 1692 01:12:07,910 --> 01:12:05,120 well i i think part of it is 1693 01:12:10,709 --> 01:12:07,920 is trying to educate your own doctor and 1694 01:12:13,510 --> 01:12:10,719 that's where the re for basically 1695 01:12:15,910 --> 01:12:13,520 if you start having chronic pain in 1696 01:12:17,189 --> 01:12:15,920 other words before you become using 1697 01:12:18,229 --> 01:12:17,199 opioids 1698 01:12:23,669 --> 01:12:18,239 there 1699 01:12:25,110 --> 01:12:23,679 that might be helpful for back pain i 1700 01:12:27,270 --> 01:12:25,120 happen to know because i suffered from 1701 01:12:30,070 --> 01:12:27,280 myself there's something called doctors 1702 01:12:32,149 --> 01:12:30,080 of physical medicine can help a lot 1703 01:12:35,910 --> 01:12:32,159 for those who are already 1704 01:12:37,990 --> 01:12:35,920 using opioids and wanting to maintain 1705 01:12:40,149 --> 01:12:38,000 dosages 1706 01:12:42,149 --> 01:12:40,159 it's difficult but some of the 1707 01:12:45,030 --> 01:12:42,159 information at the national pain 1708 01:12:48,310 --> 01:12:45,040 advocacy center and in the research of 1709 01:12:52,070 --> 01:12:48,320 stefan cortez can give you maybe some 1710 01:12:54,390 --> 01:12:52,080 ammunition to deal with your doctors 1711 01:12:57,270 --> 01:12:54,400 because what's happening overwhelmingly 1712 01:12:59,110 --> 01:12:57,280 doctors are under so much pressure 1713 01:13:04,709 --> 01:12:59,120 not to 1714 01:13:06,950 --> 01:13:04,719 forcing people out so one of the things 1715 01:13:09,350 --> 01:13:06,960 that's happened like in tennessee and 1716 01:13:11,189 --> 01:13:09,360 there's another advocate who and 1717 01:13:12,149 --> 01:13:11,199 researcher named terry lewis who i 1718 01:13:15,030 --> 01:13:12,159 follow 1719 01:13:16,390 --> 01:13:15,040 regularly so in tennessee basically they 1720 01:13:19,270 --> 01:13:16,400 shut down 1721 01:13:20,229 --> 01:13:19,280 different pain clinics uh 1722 01:13:22,870 --> 01:13:20,239 maybe because there was some 1723 01:13:24,630 --> 01:13:22,880 over-prescribing but more likely they 1724 01:13:26,709 --> 01:13:24,640 just shut it down because they had too 1725 01:13:29,669 --> 01:13:26,719 many people taking opioids even if they 1726 01:13:31,669 --> 01:13:29,679 weren't drug abusers and like tens of 1727 01:13:33,110 --> 01:13:31,679 thousands of pain patients were let out 1728 01:13:34,149 --> 01:13:33,120 on the street 1729 01:13:39,910 --> 01:13:34,159 with no 1730 01:13:41,910 --> 01:13:39,920 just mentioned crayton now yeah i wanted 1731 01:13:44,229 --> 01:13:41,920 to get into i wanted to get into that i 1732 01:13:46,950 --> 01:13:44,239 think that i i don't think it should be 1733 01:13:48,470 --> 01:13:46,960 banned but i think the evidence is 1734 01:13:52,390 --> 01:13:48,480 uneven 1735 01:13:54,709 --> 01:13:52,400 you know if if that is your only option 1736 01:13:57,830 --> 01:13:54,719 it is probably worth trying but you know 1737 01:14:00,310 --> 01:13:57,840 the evidence for it isn't really great 1738 01:14:03,270 --> 01:14:00,320 and there are some risks particularly if 1739 01:14:06,149 --> 01:14:03,280 you're basically buying it illegally so 1740 01:14:08,229 --> 01:14:06,159 it's it's there's it's it's legal it's 1741 01:14:11,350 --> 01:14:08,239 it's illegal in six states in the united 1742 01:14:13,830 --> 01:14:11,360 states i i believe it's illegal 1743 01:14:15,189 --> 01:14:13,840 or illegal it's illegal in only six 1744 01:14:17,510 --> 01:14:15,199 states okay 1745 01:14:21,510 --> 01:14:17,520 like for example in my state you can get 1746 01:14:24,149 --> 01:14:21,520 it at any like tobacco or smoke shop 1747 01:14:26,470 --> 01:14:24,159 i'm not gonna see part of what drives me 1748 01:14:28,310 --> 01:14:26,480 as a journalist and i guess i'm an 1749 01:14:30,790 --> 01:14:28,320 advocacy journalist as well although i 1750 01:14:34,390 --> 01:14:30,800 follow the forms and norms of mainstream 1751 01:14:37,510 --> 01:14:34,400 journalism is what does the evidence say 1752 01:14:38,229 --> 01:14:37,520 and and that has always shaped my views 1753 01:14:40,149 --> 01:14:38,239 so 1754 01:14:43,669 --> 01:14:40,159 all i'm saying is i don't know the 1755 01:14:45,510 --> 01:14:43,679 evidence pro and con i have a i have a 1756 01:14:47,110 --> 01:14:45,520 good word of advice 1757 01:14:49,910 --> 01:14:47,120 which is uh 1758 01:14:52,149 --> 01:14:49,920 whatever you read on facebook in some 1759 01:14:54,630 --> 01:14:52,159 private facebook group on anything 1760 01:14:56,550 --> 01:14:54,640 whether it's vaccines you gotta check it 1761 01:14:58,709 --> 01:14:56,560 yeah or cray tom 1762 01:15:01,030 --> 01:14:58,719 maybe uh think twice 1763 01:15:02,149 --> 01:15:01,040 because there's so much bad information 1764 01:15:03,990 --> 01:15:02,159 out there 1765 01:15:07,669 --> 01:15:04,000 and here's the thing about fentanyl 1766 01:15:11,750 --> 01:15:07,679 someone seeking benzona fentanyl is 1767 01:15:14,870 --> 01:15:11,760 appropriate for severe pain as a patch 1768 01:15:17,510 --> 01:15:14,880 or other legally appropriate uses for 1769 01:15:19,870 --> 01:15:17,520 severe pain but that is not what is 1770 01:15:23,030 --> 01:15:19,880 happening in the street drugs we have 1771 01:15:24,470 --> 01:15:23,040 manufactured illegal fentanyl 1772 01:15:26,149 --> 01:15:24,480 swamping 1773 01:15:28,950 --> 01:15:26,159 coming in people ordering on the 1774 01:15:31,990 --> 01:15:28,960 internet swamping from china and other 1775 01:15:33,750 --> 01:15:32,000 overseas sources and a whole bunch of 1776 01:15:36,630 --> 01:15:33,760 fake pills 1777 01:15:39,510 --> 01:15:36,640 end up on the street and 1778 01:15:43,430 --> 01:15:39,520 and so that is that is part of the 1779 01:15:45,430 --> 01:15:43,440 situation that that we're in so fentanyl 1780 01:15:49,030 --> 01:15:45,440 there's so much misinformation about it 1781 01:15:52,229 --> 01:15:49,040 so one of the myths and that is where um 1782 01:15:54,390 --> 01:15:52,239 writers like uh zach siegel and uh 1783 01:15:56,870 --> 01:15:54,400 scholars like leo boletsky pointed out 1784 01:15:59,830 --> 01:15:56,880 one of the myths about fentanyl is 1785 01:16:03,350 --> 01:15:59,840 it's so dangerous that if in your a 1786 01:16:06,149 --> 01:16:03,360 warehouse and it's in a box you know 50 1787 01:16:07,430 --> 01:16:06,159 yards away you could die from being in 1788 01:16:09,910 --> 01:16:07,440 the area 1789 01:16:12,149 --> 01:16:09,920 and there's all these reports from law 1790 01:16:14,630 --> 01:16:12,159 enforcement officers about how their 1791 01:16:15,750 --> 01:16:14,640 police were endangered by being anywhere 1792 01:16:20,950 --> 01:16:15,760 near 1793 01:16:22,630 --> 01:16:20,960 not true that's the even the illegal 1794 01:16:25,590 --> 01:16:22,640 drug but nobody should take it but 1795 01:16:27,030 --> 01:16:25,600 here's what's so bad is people can get 1796 01:16:28,390 --> 01:16:27,040 arrested 1797 01:16:30,070 --> 01:16:28,400 right now 1798 01:16:32,390 --> 01:16:30,080 if you have 1799 01:16:34,709 --> 01:16:32,400 in possession some now i this is 1800 01:16:37,270 --> 01:16:34,719 something i just read i i may be 1801 01:16:40,790 --> 01:16:37,280 incorrect on it that if you have a way 1802 01:16:42,229 --> 01:16:40,800 of testing about whether your illegally 1803 01:16:44,070 --> 01:16:42,239 obtained 1804 01:16:47,350 --> 01:16:44,080 drug 1805 01:16:50,470 --> 01:16:47,360 has fentanyl you can be arrested because 1806 01:16:53,110 --> 01:16:50,480 the testing device for fentanyl or 1807 01:16:56,709 --> 01:16:53,120 methods of testing is considered drug 1808 01:16:59,110 --> 01:16:56,719 paraphernalia now in vancouver yeah now 1809 01:17:01,189 --> 01:16:59,120 this is where this thing about just to 1810 01:17:02,950 --> 01:17:01,199 be clear though art there is a there is 1811 01:17:05,110 --> 01:17:02,960 a test because i want to be very clear 1812 01:17:06,390 --> 01:17:05,120 on this point so because it's a this is 1813 01:17:08,790 --> 01:17:06,400 a big issue that i've thought a lot 1814 01:17:11,510 --> 01:17:08,800 about there is a testing kit 1815 01:17:13,830 --> 01:17:11,520 which you can get that you can use on 1816 01:17:16,470 --> 01:17:13,840 the drugs that you obtain which will 1817 01:17:19,430 --> 01:17:16,480 tell you if the drug that you're testing 1818 01:17:21,910 --> 01:17:19,440 has fentanyl in it or not 1819 01:17:23,750 --> 01:17:21,920 right right that's yes fentanyl is so 1820 01:17:25,270 --> 01:17:23,760 deadly to me 1821 01:17:27,510 --> 01:17:25,280 everybody should be allowed to have 1822 01:17:29,590 --> 01:17:27,520 those kids if you're going to use drugs 1823 01:17:32,310 --> 01:17:29,600 right you should know what you're taking 1824 01:17:35,189 --> 01:17:32,320 yeah this kit can help you know this has 1825 01:17:37,510 --> 01:17:35,199 fentanyl in it i shouldn't use this yes 1826 01:17:39,669 --> 01:17:37,520 my that's that's my understanding that 1827 01:17:42,630 --> 01:17:39,679 there are but the question is how 1828 01:17:45,590 --> 01:17:42,640 available it is how widely 1829 01:17:47,910 --> 01:17:45,600 used is is it and to what degree do 1830 01:17:50,070 --> 01:17:47,920 different law enforcement treat having 1831 01:17:51,830 --> 01:17:50,080 that as a form of 1832 01:17:54,390 --> 01:17:51,840 of um 1833 01:17:56,550 --> 01:17:54,400 you know drug paraphernalia in contrast 1834 01:18:03,110 --> 01:17:56,560 in vancouver 1835 01:18:05,110 --> 01:18:03,120 approved site where people could obtain 1836 01:18:06,470 --> 01:18:05,120 their drugs under some kind of medical 1837 01:18:09,750 --> 01:18:06,480 monitoring 1838 01:18:13,910 --> 01:18:09,760 they were allowed to test for fentanyl 1839 01:18:16,550 --> 01:18:13,920 guess what about 85 percent of the drugs 1840 01:18:17,910 --> 01:18:16,560 that they were then allowed to test had 1841 01:18:20,149 --> 01:18:17,920 fentanyl in it 1842 01:18:22,709 --> 01:18:20,159 so that means you could prevent 85 1843 01:18:23,910 --> 01:18:22,719 percent of deaths that seems like a good 1844 01:18:25,990 --> 01:18:23,920 thing 1845 01:18:27,510 --> 01:18:26,000 you know if i have or if i had my way 1846 01:18:30,229 --> 01:18:27,520 i'd be running around handing out 1847 01:18:31,990 --> 01:18:30,239 suboxone and these testing kits to the 1848 01:18:33,669 --> 01:18:32,000 area that i grew up near you know 1849 01:18:36,229 --> 01:18:33,679 because there's just so much well 1850 01:18:38,950 --> 01:18:36,239 there's always one 1851 01:18:42,310 --> 01:18:38,960 i i don't know basically 1852 01:18:43,030 --> 01:18:42,320 under a very liberal d.a you had a kind 1853 01:18:46,709 --> 01:18:43,040 of 1854 01:18:49,830 --> 01:18:46,719 a place for safe safe drug use a little 1855 01:18:50,790 --> 01:18:49,840 pockets allowed in philadelphia that was 1856 01:18:52,229 --> 01:18:50,800 then 1857 01:18:54,870 --> 01:18:52,239 challenged 1858 01:18:57,189 --> 01:18:54,880 by the by trump administration 1859 01:18:59,510 --> 01:18:57,199 department great guys 1860 01:19:01,990 --> 01:18:59,520 and then and then it was appealed and 1861 01:19:04,149 --> 01:19:02,000 it's still up in the air and a lot of 1862 01:19:06,870 --> 01:19:04,159 people are contending it would be about 1863 01:19:09,910 --> 01:19:06,880 time that the biden administration 1864 01:19:11,270 --> 01:19:09,920 shouldn't go along with what the earlier 1865 01:19:12,950 --> 01:19:11,280 uh 1866 01:19:14,870 --> 01:19:12,960 earlier um 1867 01:19:15,750 --> 01:19:14,880 trump administration did yeah right by 1868 01:19:18,229 --> 01:19:15,760 the way 1869 01:19:20,630 --> 01:19:18,239 sixth sense posted extremely valuable 1870 01:19:23,830 --> 01:19:20,640 article from the extremely reputable 1871 01:19:26,390 --> 01:19:23,840 fentanyl test strips empower people and 1872 01:19:29,590 --> 01:19:26,400 save lives so why aren't they more 1873 01:19:32,550 --> 01:19:29,600 widespread so it's basically it's my 1874 01:19:35,669 --> 01:19:32,560 view if you are currently a user 1875 01:19:38,390 --> 01:19:35,679 one through the harm reduction network 1876 01:19:40,229 --> 01:19:38,400 that we're posting you can find doctors 1877 01:19:42,630 --> 01:19:40,239 who are prescribing suboxone if you're 1878 01:19:45,270 --> 01:19:42,640 not using it you and your friend should 1879 01:19:47,669 --> 01:19:45,280 have naloxone in your pocket or their 1880 01:19:50,870 --> 01:19:47,679 pockets and you should have these 1881 01:19:54,070 --> 01:19:50,880 fentanyl testing kits so if you're using 1882 01:19:55,990 --> 01:19:54,080 and then at least keep yourself alive 1883 01:19:57,830 --> 01:19:56,000 until you can get into meaningful 1884 01:20:00,550 --> 01:19:57,840 treatment 1885 01:20:03,270 --> 01:20:00,560 yeah yeah i i just don't understand the 1886 01:20:05,750 --> 01:20:03,280 reluctance to allow people to you know 1887 01:20:08,229 --> 01:20:05,760 if they're going to use at least let's 1888 01:20:11,270 --> 01:20:08,239 help them to use say as safely as they 1889 01:20:12,790 --> 01:20:11,280 can not be taking this debt because and 1890 01:20:14,550 --> 01:20:12,800 can we talk about the differences 1891 01:20:17,030 --> 01:20:14,560 because there's a huge difference 1892 01:20:19,110 --> 01:20:17,040 between the fentanyl that a hospital 1893 01:20:21,110 --> 01:20:19,120 would prescribe somebody like a fentanyl 1894 01:20:22,629 --> 01:20:21,120 patch and this fentanyl that's coming 1895 01:20:24,470 --> 01:20:22,639 from the united states can we talk about 1896 01:20:26,870 --> 01:20:24,480 the differences between yeah there are 1897 01:20:28,870 --> 01:20:26,880 huge differences and i 1898 01:20:31,110 --> 01:20:28,880 i can't give you the chemical breakdown 1899 01:20:32,950 --> 01:20:31,120 but there is a legitimate use what 1900 01:20:34,709 --> 01:20:32,960 happens in the media coverage and law 1901 01:20:36,709 --> 01:20:34,719 enforcement coverage 1902 01:20:39,669 --> 01:20:36,719 they actually try to reduce 1903 01:20:41,990 --> 01:20:39,679 you know prescribing of fentanyl patches 1904 01:20:43,430 --> 01:20:42,000 for people with cancer pain 1905 01:20:45,030 --> 01:20:43,440 and that's one of the things that i've 1906 01:20:47,669 --> 01:20:45,040 learned is 1907 01:20:50,709 --> 01:20:47,679 following it so what i'm getting at is 1908 01:20:52,870 --> 01:20:50,719 there are appropriate uses i don't know 1909 01:20:55,110 --> 01:20:52,880 all the methods of administration of 1910 01:20:58,390 --> 01:20:55,120 prescribed fentanyl 1911 01:21:01,990 --> 01:20:58,400 uh often with patches or other sort of 1912 01:21:03,430 --> 01:21:02,000 methods of careful use for people in 1913 01:21:04,470 --> 01:21:03,440 severe pain 1914 01:21:07,189 --> 01:21:04,480 versus 1915 01:21:07,990 --> 01:21:07,199 the crap coming in from china 1916 01:21:11,590 --> 01:21:08,000 that 1917 01:21:15,110 --> 01:21:11,600 is allowed to kind of mingle in the 1918 01:21:17,669 --> 01:21:15,120 uh it's either secretly put inside 1919 01:21:20,790 --> 01:21:17,679 heroin and other things and for the drug 1920 01:21:23,270 --> 01:21:20,800 dealers oh this is a great boon because 1921 01:21:25,669 --> 01:21:23,280 they don't need as much heroin 1922 01:21:29,110 --> 01:21:25,679 piles of heroin because they're getting 1923 01:21:31,510 --> 01:21:29,120 so much kick from the fentanyl downside 1924 01:21:32,950 --> 01:21:31,520 some of their customers are gonna die 1925 01:21:35,510 --> 01:21:32,960 okay 1926 01:21:39,990 --> 01:21:35,520 but but then there's that lacing the 1927 01:21:41,430 --> 01:21:40,000 drug with fentanyl then secondly 1928 01:21:43,990 --> 01:21:41,440 secondly 1929 01:21:45,189 --> 01:21:44,000 they are then producing counterfeit 1930 01:21:48,070 --> 01:21:45,199 pills 1931 01:21:50,390 --> 01:21:48,080 that look like oh vitamin 1932 01:21:52,709 --> 01:21:50,400 you know percocet 1933 01:21:54,229 --> 01:21:52,719 percocet 1934 01:21:56,550 --> 01:21:54,239 and the people should know by now there 1935 01:21:59,590 --> 01:21:56,560 isn't that much legally circulating 1936 01:22:03,189 --> 01:21:59,600 oxycontin anymore in the wake of all the 1937 01:22:05,430 --> 01:22:03,199 prosecutions and reductions so but the 1938 01:22:06,790 --> 01:22:05,440 notion that you would buy the pills on 1939 01:22:09,270 --> 01:22:06,800 the street 1940 01:22:10,550 --> 01:22:09,280 and then it could have fentanyl is super 1941 01:22:13,830 --> 01:22:10,560 scary 1942 01:22:15,990 --> 01:22:13,840 and it it's really 1943 01:22:18,470 --> 01:22:16,000 you know and this is what is so 1944 01:22:19,430 --> 01:22:18,480 horrifying to me is that 1945 01:22:21,510 --> 01:22:19,440 that 1946 01:22:24,470 --> 01:22:21,520 driving this all 1947 01:22:25,350 --> 01:22:24,480 is a sort of punitive mindset 1948 01:22:26,709 --> 01:22:25,360 that 1949 01:22:29,270 --> 01:22:26,719 essentially 1950 01:22:31,830 --> 01:22:29,280 people abusing drugs are bad people but 1951 01:22:33,750 --> 01:22:31,840 there's a sec separate myth that's being 1952 01:22:37,030 --> 01:22:33,760 spawned by dopesick which i'll get to in 1953 01:22:38,790 --> 01:22:37,040 a second but the basically driving it is 1954 01:22:40,790 --> 01:22:38,800 we got to punish drug abusers and 1955 01:22:43,189 --> 01:22:40,800 they're bad people okay 1956 01:22:45,830 --> 01:22:43,199 now there's a new there's a myth that's 1957 01:22:48,790 --> 01:22:45,840 emerged for all of the legitimate 1958 01:22:52,070 --> 01:22:48,800 excellent reporting about the corrupted 1959 01:22:54,149 --> 01:22:52,080 corrupted drug industry and like in the 1960 01:22:57,430 --> 01:22:54,159 movie and book dopestick 1961 01:23:00,390 --> 01:22:57,440 and that myth i hate to say this the 1962 01:23:04,070 --> 01:23:00,400 myth that's promoted so they swamped the 1963 01:23:06,870 --> 01:23:04,080 market they over medicated they bribed 1964 01:23:08,870 --> 01:23:06,880 doctors bribe researchers bribe the 1965 01:23:10,870 --> 01:23:08,880 joint commission essentially bribe the 1966 01:23:13,030 --> 01:23:10,880 fda and 1967 01:23:15,270 --> 01:23:13,040 bribe the d.a i mean they did everything 1968 01:23:18,229 --> 01:23:15,280 possible to corrupt everything 1969 01:23:21,669 --> 01:23:18,239 but the the narrative that emerges all 1970 01:23:23,669 --> 01:23:21,679 that's accurate is the innocent white 1971 01:23:26,229 --> 01:23:23,679 working-class person 1972 01:23:27,270 --> 01:23:26,239 who ends up getting addicted which does 1973 01:23:30,149 --> 01:23:27,280 happen 1974 01:23:32,470 --> 01:23:30,159 but the heart but one of the one of the 1975 01:23:36,470 --> 01:23:32,480 data points that is 1976 01:23:39,830 --> 01:23:36,480 widely ignored is you often see 1977 01:23:44,550 --> 01:23:39,840 a phrase where someone says they started 1978 01:23:46,950 --> 01:23:44,560 using heroin or illegal opioids and and 1979 01:23:50,709 --> 01:23:46,960 almost always began with prescription 1980 01:23:53,510 --> 01:23:50,719 pills but in eighty percent of the cases 1981 01:23:56,870 --> 01:23:53,520 where people end up misusing opioids 1982 01:23:57,990 --> 01:23:56,880 they got the pills illegally from family 1983 01:24:00,629 --> 01:23:58,000 friends 1984 01:24:02,550 --> 01:24:00,639 medicine cabinets and so where i grew up 1985 01:24:04,470 --> 01:24:02,560 it was very very common that people sold 1986 01:24:06,229 --> 01:24:04,480 pills yeah and then they're selling they 1987 01:24:08,709 --> 01:24:06,239 would sell they would sell percocet for 1988 01:24:10,790 --> 01:24:08,719 like ten dollars oxies i don't know 1989 01:24:12,709 --> 01:24:10,800 twenty dollars whatever you know pretty 1990 01:24:15,350 --> 01:24:12,719 sentinel era they might have been the 1991 01:24:17,270 --> 01:24:15,360 actual drug but people 1992 01:24:19,430 --> 01:24:17,280 it would flaunt people would obtain it 1993 01:24:22,629 --> 01:24:19,440 then the other thing is 1994 01:24:27,030 --> 01:24:22,639 about two-thirds of people 1995 01:24:29,030 --> 01:24:27,040 who end up misusing drugs often had some 1996 01:24:30,709 --> 01:24:29,040 earlier history 1997 01:24:33,110 --> 01:24:30,719 and i'm not blaming them i'm just 1998 01:24:35,750 --> 01:24:33,120 explaining the reality had some earlier 1999 01:24:38,390 --> 01:24:35,760 history of drug misuse 2000 01:24:42,390 --> 01:24:38,400 whether it was coke or math or things 2001 01:24:44,629 --> 01:24:42,400 like that but the narrative that is now 2002 01:24:47,110 --> 01:24:44,639 and i i learned this from brook feldman 2003 01:24:48,709 --> 01:24:47,120 as a great philadelphia 2004 01:24:50,310 --> 01:24:48,719 leading of the pennsylvania harm 2005 01:24:52,790 --> 01:24:50,320 reduction network 2006 01:24:55,350 --> 01:24:52,800 and um he helped me understand the 2007 01:24:57,750 --> 01:24:55,360 notion of the innocent white person so 2008 01:25:00,870 --> 01:24:57,760 the narrative is 2009 01:25:03,830 --> 01:25:00,880 nice noble white working-class guy who 2010 01:25:06,790 --> 01:25:03,840 never ever did anything illegal proper 2011 01:25:08,870 --> 01:25:06,800 maybe drank or two at the friendly bar 2012 01:25:11,830 --> 01:25:08,880 comes in and then there's a corrupted 2013 01:25:15,189 --> 01:25:11,840 doctor who's been bribed with you know 2014 01:25:18,229 --> 01:25:15,199 free trips and lies to then give them 2015 01:25:21,590 --> 01:25:18,239 oxycontin they become addicted and then 2016 01:25:23,910 --> 01:25:21,600 they ultimately die or do street drugs 2017 01:25:26,870 --> 01:25:23,920 and that is the narrative and and but 2018 01:25:31,030 --> 01:25:26,880 reality is uh you know most of the 2019 01:25:33,189 --> 01:25:31,040 people who end up getting addicted 2020 01:25:35,270 --> 01:25:33,199 you know had some previous experience 2021 01:25:39,189 --> 01:25:35,280 that doesn't mean they shouldn't get the 2022 01:25:43,430 --> 01:25:39,199 best option of care but as long as we 2023 01:25:44,629 --> 01:25:43,440 as long as we keep up this mythology of 2024 01:25:47,830 --> 01:25:44,639 the 2025 01:25:50,149 --> 01:25:47,840 totally innocent white person who's 2026 01:25:52,550 --> 01:25:50,159 completely blameless 2027 01:25:55,030 --> 01:25:52,560 and has no history of addiction then 2028 01:25:57,430 --> 01:25:55,040 that helps shape a lot of our responses 2029 01:25:59,990 --> 01:25:57,440 and what is our response let's crack 2030 01:26:02,709 --> 01:26:00,000 down on those crooked drug companies 2031 01:26:05,110 --> 01:26:02,719 from prescribing and let's stop those 2032 01:26:07,189 --> 01:26:05,120 evil crooked doctors from prescribing 2033 01:26:09,990 --> 01:26:07,199 any opioid because that's the only 2034 01:26:11,270 --> 01:26:10,000 reasonable conclusion you can draw from 2035 01:26:15,189 --> 01:26:11,280 books that are 2036 01:26:19,030 --> 01:26:15,199 really great reporting from dopesick 2037 01:26:22,229 --> 01:26:19,040 and and and dreamland but beth macy 2038 01:26:24,950 --> 01:26:22,239 wrote ropesick and executive produced 2039 01:26:27,030 --> 01:26:24,960 emphasizes the value in the latter part 2040 01:26:30,149 --> 01:26:27,040 of her book in the latter part of her 2041 01:26:32,470 --> 01:26:30,159 series that she's producing about the 2042 01:26:34,550 --> 01:26:32,480 value of suboxone and 2043 01:26:38,229 --> 01:26:34,560 medicated assisted treatment for people 2044 01:26:41,750 --> 01:26:38,239 who do become addicted but but but the 2045 01:26:45,189 --> 01:26:41,760 main thrust of all our policies is 2046 01:26:47,669 --> 01:26:45,199 let's stop prescribing 2047 01:26:51,350 --> 01:26:47,679 opioids and they do there's so many 2048 01:26:52,550 --> 01:26:51,360 incentives against prescribing and i 2049 01:26:55,110 --> 01:26:52,560 write i've written about it for 2050 01:26:58,229 --> 01:26:55,120 huffington post in particular i wrote 2051 01:27:01,189 --> 01:26:58,239 about this wonderful doctor in 2052 01:27:02,229 --> 01:27:01,199 montana who had a great track record and 2053 01:27:04,870 --> 01:27:02,239 he had 2054 01:27:06,790 --> 01:27:04,880 he inherited the uh 2055 01:27:07,910 --> 01:27:06,800 the patient base 2056 01:27:12,470 --> 01:27:07,920 of 2057 01:27:14,629 --> 01:27:12,480 business and he began his 2058 01:27:17,189 --> 01:27:14,639 they were all severe chronic pain and 2059 01:27:18,550 --> 01:27:17,199 they had they were taking opioids most 2060 01:27:21,110 --> 01:27:18,560 legitimately 2061 01:27:23,510 --> 01:27:21,120 and his patient base 2062 01:27:26,149 --> 01:27:23,520 went up enormously and then there's the 2063 01:27:28,870 --> 01:27:26,159 prescription drug monitoring program 2064 01:27:31,110 --> 01:27:28,880 made him look like a pill doctor and 2065 01:27:34,470 --> 01:27:31,120 then the state licensing board went 2066 01:27:37,350 --> 01:27:34,480 after him for like five six years he 2067 01:27:40,149 --> 01:27:37,360 ultimately proved his innocence of these 2068 01:27:41,189 --> 01:27:40,159 charges but he doesn't he's now 2069 01:27:44,310 --> 01:27:41,199 basically 2070 01:27:45,189 --> 01:27:44,320 working as a medical advisor to 2071 01:27:48,070 --> 01:27:45,199 um 2072 01:27:50,629 --> 01:27:48,080 marijuana clinics you know in montana 2073 01:27:53,510 --> 01:27:50,639 but he's literally was honored as like 2074 01:27:55,830 --> 01:27:53,520 the best doctor in butte montana and 2075 01:27:56,950 --> 01:27:55,840 he's not regularly treating anyone for 2076 01:27:59,270 --> 01:27:56,960 anything 2077 01:28:01,990 --> 01:27:59,280 because he's been basically 2078 01:28:05,030 --> 01:28:02,000 harassed out of his regular work and 2079 01:28:09,310 --> 01:28:05,040 there was another doctor in california 2080 01:28:12,390 --> 01:28:09,320 uh a forest tenant who who was a 2081 01:28:15,189 --> 01:28:12,400 phenomenally sophisticated researcher 2082 01:28:17,990 --> 01:28:15,199 and treatment who um 2083 01:28:21,110 --> 01:28:18,000 treated people who were damaged by what 2084 01:28:21,910 --> 01:28:21,120 were called epidural steroid injections 2085 01:28:30,229 --> 01:28:21,920 and 2086 01:28:32,149 --> 01:28:30,239 article on it by sheila kaplan 2087 01:28:34,149 --> 01:28:32,159 and basically 2088 01:28:36,470 --> 01:28:34,159 people are being if they want to have 2089 01:28:39,510 --> 01:28:36,480 any opioids at all they're being forced 2090 01:28:41,590 --> 01:28:39,520 into these highly dangerous 2091 01:28:44,470 --> 01:28:41,600 medical procedures that don't really 2092 01:28:46,629 --> 01:28:44,480 cure their pain in most cases and one of 2093 01:28:48,870 --> 01:28:46,639 them is epidural steroid 2094 01:28:50,470 --> 01:28:48,880 injections and this could be and this 2095 01:28:52,470 --> 01:28:50,480 could be very dangerous right for 2096 01:28:55,030 --> 01:28:52,480 something really dangerous causes a lot 2097 01:28:58,550 --> 01:28:55,040 of pain often paralysis 2098 01:29:01,430 --> 01:28:58,560 and yet uh it's still going on and now 2099 01:29:03,750 --> 01:29:01,440 they basically black and it's more more 2100 01:29:06,790 --> 01:29:03,760 lucrative for the doctors so a lot of 2101 01:29:08,870 --> 01:29:06,800 the pain clinics are saying hey if you 2102 01:29:11,270 --> 01:29:08,880 want to have me as a doctor maybe get a 2103 01:29:13,750 --> 01:29:11,280 little bit opioid you have to go through 2104 01:29:16,390 --> 01:29:13,760 they're blackmailing and extorting their 2105 01:29:17,430 --> 01:29:16,400 patients into epidural steroid 2106 01:29:20,390 --> 01:29:17,440 injections 2107 01:29:22,149 --> 01:29:20,400 credence was treating all of these 2108 01:29:25,590 --> 01:29:22,159 victims 2109 01:29:28,470 --> 01:29:25,600 of of this horrible procedure 2110 01:29:31,110 --> 01:29:28,480 and then he was forced out 2111 01:29:31,750 --> 01:29:31,120 of his practice and he's still the best 2112 01:29:33,830 --> 01:29:31,760 and 2113 01:29:35,669 --> 01:29:33,840 it's called an act with 2114 01:29:37,830 --> 01:29:35,679 an acroiditis i don't necessarily have 2115 01:29:40,390 --> 01:29:37,840 to pronounce it accurately but it's a 2116 01:29:42,310 --> 01:29:40,400 side effect of this procedure he was the 2117 01:29:44,550 --> 01:29:42,320 and so he had a lot of chronic pain 2118 01:29:47,189 --> 01:29:44,560 patients who 2119 01:29:50,470 --> 01:29:47,199 suffered through this horrible procedure 2120 01:29:53,350 --> 01:29:50,480 and uh terry lewis who's a scholar uh in 2121 01:29:56,470 --> 01:29:53,360 tennessee um affiliated with a lot of at 2122 01:29:59,110 --> 01:29:56,480 a top rehabilitation expert is a big 2123 01:30:00,629 --> 01:29:59,120 knowledgeable about this topic they 2124 01:30:03,910 --> 01:30:00,639 basically 2125 01:30:06,790 --> 01:30:03,920 uh became refugees known as the kind of 2126 01:30:08,790 --> 01:30:06,800 chronic pain refugees and then they went 2127 01:30:10,070 --> 01:30:08,800 to him for treatment then they shut him 2128 01:30:13,110 --> 01:30:10,080 down 2129 01:30:15,830 --> 01:30:13,120 you see it's just yeah so crazy terrible 2130 01:30:18,310 --> 01:30:15,840 it's terrible what's happening so 2131 01:30:20,070 --> 01:30:18,320 we've covered a lot of ground here but 2132 01:30:21,750 --> 01:30:20,080 but what i want to know is what what do 2133 01:30:24,149 --> 01:30:21,760 you think that the 2134 01:30:26,629 --> 01:30:24,159 the current administration is doing or 2135 01:30:29,189 --> 01:30:26,639 not doing that they should be doing to 2136 01:30:32,070 --> 01:30:29,199 try to get a handle on this thing and 2137 01:30:34,709 --> 01:30:32,080 and fix what has been a comedy of errors 2138 01:30:37,350 --> 01:30:34,719 so far through multiple administrations 2139 01:30:40,390 --> 01:30:37,360 this failed drug war 2140 01:30:42,709 --> 01:30:40,400 there are a few things the question is 2141 01:30:44,790 --> 01:30:42,719 how to get the change to happen so one 2142 01:30:46,870 --> 01:30:44,800 of the things is 2143 01:30:49,750 --> 01:30:46,880 most federal health on the issue of 2144 01:30:53,030 --> 01:30:49,760 chronic pain and opioids most federal 2145 01:30:54,709 --> 01:30:53,040 health agencies have kind of admitted oh 2146 01:30:57,270 --> 01:30:54,719 by the way you shouldn't do force 2147 01:30:59,510 --> 01:30:57,280 tapering too fast it's dangerous and 2148 01:31:03,270 --> 01:30:59,520 harmful but they haven't bothered to 2149 01:31:05,830 --> 01:31:03,280 publicize or inform clinicians about it 2150 01:31:06,709 --> 01:31:05,840 so they they should be publicizing their 2151 01:31:11,030 --> 01:31:06,719 own 2152 01:31:12,470 --> 01:31:11,040 monitor 2153 01:31:15,350 --> 01:31:12,480 what state 2154 01:31:18,629 --> 01:31:15,360 licensing boards insurers and others are 2155 01:31:21,830 --> 01:31:18,639 doing to violate the recommendations of 2156 01:31:24,149 --> 01:31:21,840 federal agencies and now the cdc is kind 2157 01:31:25,910 --> 01:31:24,159 of in this ambivalent position where 2158 01:31:27,830 --> 01:31:25,920 just two years ago they said hey 2159 01:31:30,629 --> 01:31:27,840 everybody uh 2160 01:31:32,709 --> 01:31:30,639 please don't misapply our earlier 2016 2161 01:31:35,590 --> 01:31:32,719 guidelines and now it looks like they 2162 01:31:37,590 --> 01:31:35,600 may be moving back to reinforcing the 2163 01:31:39,910 --> 01:31:37,600 messaging of that that's still up in the 2164 01:31:41,669 --> 01:31:39,920 air so one thing is 2165 01:31:44,709 --> 01:31:41,679 it should be part of 2166 01:31:45,830 --> 01:31:44,719 medicaid with the tools of medicaid and 2167 01:31:48,229 --> 01:31:45,840 that's where 2168 01:31:50,709 --> 01:31:48,239 if you get money from the federal 2169 01:31:53,669 --> 01:31:50,719 government through medicaid or medicare 2170 01:31:56,390 --> 01:31:53,679 you shouldn't be engaging in 2171 01:31:58,790 --> 01:31:56,400 horrifically terrible 2172 01:32:01,830 --> 01:31:58,800 medication policies or addiction 2173 01:32:04,470 --> 01:32:01,840 treatment so one of the things 2174 01:32:07,750 --> 01:32:04,480 yes opioids are great for long-term pain 2175 01:32:10,149 --> 01:32:07,760 too what i'm what i'm saying is that we 2176 01:32:13,430 --> 01:32:10,159 have the tools that 2177 01:32:16,790 --> 01:32:13,440 we can save lives prevent suicides and 2178 01:32:19,030 --> 01:32:16,800 prevent overdose addictions all of that 2179 01:32:20,550 --> 01:32:19,040 if we use the tools 2180 01:32:23,910 --> 01:32:20,560 that are currently available through 2181 01:32:26,550 --> 01:32:23,920 funding so another element of it is if 2182 01:32:28,149 --> 01:32:26,560 we have two-thirds 2183 01:32:30,390 --> 01:32:28,159 of all 2184 01:32:34,229 --> 01:32:30,400 treatment facilities in the united 2185 01:32:35,189 --> 01:32:34,239 states refusing to use suboxone that can 2186 01:32:38,870 --> 01:32:35,199 cut 2187 01:32:42,229 --> 01:32:38,880 overdoses at least 50 percent you 2188 01:32:43,430 --> 01:32:42,239 shouldn't get a penny of federal money 2189 01:32:46,229 --> 01:32:43,440 yeah they shouldn't get any federal 2190 01:32:49,750 --> 01:32:46,239 you're not using evidence-based care 2191 01:32:52,229 --> 01:32:49,760 it's just like forget it now people will 2192 01:32:54,709 --> 01:32:52,239 follow the money kind of like from uh 2193 01:32:58,149 --> 01:32:54,719 woodward and bernstein and deep throat 2194 01:33:01,750 --> 01:32:58,159 follow the money people will paddle away 2195 01:33:03,750 --> 01:33:01,760 and will follow if we provide incentives 2196 01:33:05,750 --> 01:33:03,760 so that's the other thing is we have to 2197 01:33:08,310 --> 01:33:05,760 get rid of all this paperwork and 2198 01:33:10,629 --> 01:33:08,320 barriers and training requirements and 2199 01:33:14,550 --> 01:33:10,639 these patient limits that prevent 2200 01:33:17,030 --> 01:33:14,560 doctors from prescribing suboxone again 2201 01:33:18,550 --> 01:33:17,040 that is something that could be done and 2202 01:33:21,030 --> 01:33:18,560 there's little 2203 01:33:23,990 --> 01:33:21,040 work around the edges by the 2204 01:33:26,950 --> 01:33:24,000 biden administration but not enough and 2205 01:33:29,750 --> 01:33:26,960 it should be front and center 2206 01:33:33,189 --> 01:33:29,760 and and so there's a role both in bully 2207 01:33:34,310 --> 01:33:33,199 pulpit on and of course harm reduction 2208 01:33:35,510 --> 01:33:34,320 treatments 2209 01:33:38,229 --> 01:33:35,520 uh 2210 01:33:40,470 --> 01:33:38,239 you know and basically promoting what 2211 01:33:42,709 --> 01:33:40,480 works for harm reduction 2212 01:33:44,790 --> 01:33:42,719 i don't expect at this point the federal 2213 01:33:47,510 --> 01:33:44,800 government if biden would want to get 2214 01:33:50,070 --> 01:33:47,520 reelected oh by the way i'm promoting 2215 01:33:52,149 --> 01:33:50,080 the ending of the controlled substances 2216 01:33:55,910 --> 01:33:52,159 act and everyone can possess small 2217 01:33:56,870 --> 01:33:55,920 amounts of cocaine and um 2218 01:34:02,550 --> 01:33:56,880 uh 2219 01:34:04,629 --> 01:34:02,560 don't you think though that there is 2220 01:34:06,790 --> 01:34:04,639 that there is some changing attitudes 2221 01:34:09,030 --> 01:34:06,800 towards drug legalization we've seen a 2222 01:34:11,910 --> 01:34:09,040 proliferation oh yes i think we've seen 2223 01:34:16,070 --> 01:34:11,920 this with marijuana it's it's in my 2224 01:34:16,830 --> 01:34:16,080 state it is legal for uh medical use um 2225 01:34:21,590 --> 01:34:16,840 and 2226 01:34:23,189 --> 01:34:21,600 get to get it legally to get the 2227 01:34:25,270 --> 01:34:23,199 prescription to get the card but it 2228 01:34:27,669 --> 01:34:25,280 seems like now they're really opening it 2229 01:34:29,990 --> 01:34:27,679 up you know for things like anxiety you 2230 01:34:32,709 --> 01:34:30,000 can get it for anxiety there's a 2231 01:34:34,950 --> 01:34:32,719 marijuana industry that is built on this 2232 01:34:37,030 --> 01:34:34,960 trying to spread it but apparently 2233 01:34:38,390 --> 01:34:37,040 unless i'm mistaken i know this sounds 2234 01:34:41,830 --> 01:34:38,400 crazy but 2235 01:34:44,310 --> 01:34:41,840 heroin and marijuana are both considered 2236 01:34:45,189 --> 01:34:44,320 category one 2237 01:34:50,310 --> 01:34:45,199 no 2238 01:34:54,310 --> 01:34:50,320 medical use even though there's actual 2239 01:34:56,950 --> 01:34:54,320 medical marijuana clinics the csa and 2240 01:34:58,390 --> 01:34:56,960 the dea haven't changed anything you 2241 01:35:00,390 --> 01:34:58,400 know this is going by states have 2242 01:35:02,550 --> 01:35:00,400 decided to legalize but it's still 2243 01:35:05,030 --> 01:35:02,560 federally it's still federally illegal 2244 01:35:07,510 --> 01:35:05,040 but so far the states haven't stepped in 2245 01:35:09,350 --> 01:35:07,520 and gone against the wishes or i'm sorry 2246 01:35:11,669 --> 01:35:09,360 so far the federal government has not 2247 01:35:13,510 --> 01:35:11,679 stepped in and gone against the wishes 2248 01:35:15,430 --> 01:35:13,520 of the local states and then there's 2249 01:35:17,109 --> 01:35:15,440 some they're allowing it they're doing 2250 01:35:19,189 --> 01:35:17,119 on the medical clinics which is 2251 01:35:21,109 --> 01:35:19,199 apparently you can't 2252 01:35:23,030 --> 01:35:21,119 there's some limits on how they use the 2253 01:35:24,629 --> 01:35:23,040 money or cash 2254 01:35:26,470 --> 01:35:24,639 and so there's limits on whether they 2255 01:35:28,310 --> 01:35:26,480 can deposit the money 2256 01:35:30,070 --> 01:35:28,320 which yeah because it's all cash 2257 01:35:31,750 --> 01:35:30,080 business yeah it's a cash bit it's a 2258 01:35:33,669 --> 01:35:31,760 cash business because they're not 2259 01:35:36,149 --> 01:35:33,679 allowed legally 2260 01:35:40,629 --> 01:35:36,159 to create 2261 01:35:43,430 --> 01:35:40,639 all that money in yeah where they're 2262 01:35:44,950 --> 01:35:43,440 providing a legal service 2263 01:35:46,870 --> 01:35:44,960 you know i mean 2264 01:35:48,550 --> 01:35:46,880 so that's something that can be changed 2265 01:35:50,390 --> 01:35:48,560 the question is 2266 01:35:51,510 --> 01:35:50,400 i do think that 2267 01:35:54,390 --> 01:35:51,520 that 2268 01:35:55,590 --> 01:35:54,400 enough people are dying at such high 2269 01:35:57,910 --> 01:35:55,600 levels 2270 01:35:59,189 --> 01:35:57,920 that the harm reduction message is 2271 01:36:02,470 --> 01:35:59,199 spreading 2272 01:36:05,830 --> 01:36:02,480 and some of that hopeful uh news about 2273 01:36:08,629 --> 01:36:05,840 that is in the book on drugging 2274 01:36:11,430 --> 01:36:08,639 undrugging america by maya says all of 2275 01:36:13,510 --> 01:36:11,440 it but i do think the federal government 2276 01:36:14,950 --> 01:36:13,520 needs to do a lot more 2277 01:36:17,350 --> 01:36:14,960 and here's something that's kind of 2278 01:36:19,510 --> 01:36:17,360 important politically now sam cannonis 2279 01:36:22,629 --> 01:36:19,520 did an amazing analysis so he wrote one 2280 01:36:25,350 --> 01:36:22,639 of the pioneering books about called 2281 01:36:29,189 --> 01:36:25,360 dreamland that looked at both the fake 2282 01:36:31,669 --> 01:36:29,199 marketing by purdue pharma and then when 2283 01:36:34,950 --> 01:36:31,679 there was a cut back in legal 2284 01:36:38,390 --> 01:36:34,960 prescribing how a particularly savvy m 2285 01:36:41,830 --> 01:36:38,400 small mexican drug cartel 2286 01:36:44,950 --> 01:36:41,840 moved in to sell heroin in middle class 2287 01:36:46,550 --> 01:36:44,960 america it wasn't the big famous cartels 2288 01:36:50,390 --> 01:36:46,560 they had this policy where they gave 2289 01:36:52,390 --> 01:36:50,400 their drug dealers and drug drug honchos 2290 01:36:55,430 --> 01:36:52,400 they would put them on salary they would 2291 01:36:57,590 --> 01:36:55,440 give them health insurance 2292 01:37:00,470 --> 01:36:57,600 they would worm their way into these 2293 01:37:02,310 --> 01:37:00,480 suburban industrial de-industrializing 2294 01:37:04,950 --> 01:37:02,320 middle-class areas 2295 01:37:07,510 --> 01:37:04,960 and they would literally just show up at 2296 01:37:10,149 --> 01:37:07,520 methadone clinics where people were in 2297 01:37:11,270 --> 01:37:10,159 line and then they would like hype 2298 01:37:14,870 --> 01:37:11,280 heroin 2299 01:37:17,750 --> 01:37:14,880 okay to them and they helped create a 2300 01:37:20,950 --> 01:37:17,760 heroin market which previously white 2301 01:37:23,990 --> 01:37:20,960 suburbanites were not taking in droves 2302 01:37:26,709 --> 01:37:24,000 okay or even white urban dwellers were 2303 01:37:29,189 --> 01:37:26,719 not taking drugs and these guys kind of 2304 01:37:33,189 --> 01:37:29,199 took advantage of 2305 01:37:35,830 --> 01:37:33,199 the advanced guard of of false marketing 2306 01:37:38,390 --> 01:37:35,840 for opioids and then when people got 2307 01:37:40,709 --> 01:37:38,400 addicted they said hey now you're having 2308 01:37:43,510 --> 01:37:40,719 trouble we got something even better for 2309 01:37:45,990 --> 01:37:43,520 you here's heroin and by this point the 2310 01:37:47,030 --> 01:37:46,000 people are willing to take it so there's 2311 01:37:49,990 --> 01:37:47,040 you know 2312 01:37:52,790 --> 01:37:50,000 a very savvy smaller mexican drug it 2313 01:37:55,590 --> 01:37:52,800 wasn't el chapo it's a much smaller 2314 01:37:58,149 --> 01:37:55,600 savvy that fell that wasn't under the 2315 01:38:01,109 --> 01:37:58,159 radar of the dea to the degree that the 2316 01:38:02,709 --> 01:38:01,119 much bigger uh the much bigger drug 2317 01:38:05,109 --> 01:38:02,719 cartels were 2318 01:38:07,189 --> 01:38:05,119 so there's a work you could do 2319 01:38:09,350 --> 01:38:07,199 i wanted to ask you two what is it that 2320 01:38:12,070 --> 01:38:09,360 we can learn from these european 2321 01:38:14,070 --> 01:38:12,080 countries several which have completely 2322 01:38:16,550 --> 01:38:14,080 legalized the use of 2323 01:38:19,189 --> 01:38:16,560 these drugs that are illegal here i mean 2324 01:38:22,470 --> 01:38:19,199 does it does making it legal 2325 01:38:24,790 --> 01:38:22,480 reduce reduce crime and reduce the harm 2326 01:38:27,189 --> 01:38:24,800 that is caused by drugs yeah it's it's 2327 01:38:29,270 --> 01:38:27,199 legal but it's it's it's kind of 2328 01:38:31,830 --> 01:38:29,280 supervised legal 2329 01:38:34,310 --> 01:38:31,840 in other words what i'm trying now 2330 01:38:36,149 --> 01:38:34,320 that's where chasing the scream is the 2331 01:38:38,470 --> 01:38:36,159 book to read on this because he talks a 2332 01:38:39,910 --> 01:38:38,480 lot about the european model so 2333 01:38:42,629 --> 01:38:39,920 basically 2334 01:38:45,510 --> 01:38:42,639 you don't put people in jail 2335 01:38:49,109 --> 01:38:45,520 and they are available to get their 2336 01:38:52,550 --> 01:38:49,119 drugs through medically approved clinics 2337 01:38:53,910 --> 01:38:52,560 okay and then separately 2338 01:38:56,149 --> 01:38:53,920 separately 2339 01:38:57,830 --> 01:38:56,159 then they're being routed into effective 2340 01:38:59,430 --> 01:38:57,840 drug treatment if they want to get off 2341 01:39:01,510 --> 01:38:59,440 the drugs 2342 01:39:04,310 --> 01:39:01,520 so because they're under the umbrella of 2343 01:39:06,149 --> 01:39:04,320 a medically approved way to obtain clean 2344 01:39:09,270 --> 01:39:06,159 needles or 2345 01:39:11,669 --> 01:39:09,280 safe opioids or whatever their drug 2346 01:39:14,149 --> 01:39:11,679 problem is and they're not sent into 2347 01:39:16,470 --> 01:39:14,159 jail and then allowed to turn into cold 2348 01:39:19,030 --> 01:39:16,480 turkey get on the street and then die 2349 01:39:21,590 --> 01:39:19,040 from overdoses within a week so their 2350 01:39:25,109 --> 01:39:21,600 whole model is different it is not 2351 01:39:27,109 --> 01:39:25,119 punitive and is not stigmatizing it's 2352 01:39:29,590 --> 01:39:27,119 sort of we want to help you 2353 01:39:31,669 --> 01:39:29,600 and one of the ways they do so it is not 2354 01:39:34,390 --> 01:39:31,679 you know when they talk about legalizing 2355 01:39:37,510 --> 01:39:34,400 i guess if you legalize 2356 01:39:39,030 --> 01:39:37,520 we had in some ways kind of unofficial 2357 01:39:43,430 --> 01:39:39,040 legalization 2358 01:39:45,669 --> 01:39:43,440 of crack in the 1980s when in the black 2359 01:39:48,149 --> 01:39:45,679 areas white cops and enforcement would 2360 01:39:50,310 --> 01:39:48,159 just give up and not bother to go in and 2361 01:39:52,070 --> 01:39:50,320 it's not worth the paperwork yeah yeah 2362 01:39:54,470 --> 01:39:52,080 they didn't want to bother to enforce 2363 01:39:56,550 --> 01:39:54,480 and then it spread like wildfire 2364 01:39:57,590 --> 01:39:56,560 but that is different than the portugal 2365 01:39:59,030 --> 01:39:57,600 model 2366 01:40:05,030 --> 01:39:59,040 which is 2367 01:40:08,470 --> 01:40:05,040 is medically sanctioned 2368 01:40:10,390 --> 01:40:08,480 and no jail for drug use and treatment 2369 01:40:11,669 --> 01:40:10,400 options those are some of the key 2370 01:40:13,350 --> 01:40:11,679 elements 2371 01:40:15,350 --> 01:40:13,360 so basically instead of locking these 2372 01:40:18,550 --> 01:40:15,360 people up and putting them in prison 2373 01:40:20,070 --> 01:40:18,560 they they they direct them to treatment 2374 01:40:22,629 --> 01:40:20,080 plans 2375 01:40:24,629 --> 01:40:22,639 right and things like that to to try to 2376 01:40:26,870 --> 01:40:24,639 so their their approach is more it's a 2377 01:40:28,629 --> 01:40:26,880 health problem not a crime problem yes 2378 01:40:31,910 --> 01:40:28,639 it's treating it as a health problem in 2379 01:40:34,310 --> 01:40:31,920 which it is it is a health problem like 2380 01:40:36,870 --> 01:40:34,320 you know i personally 2381 01:40:38,870 --> 01:40:36,880 i have my own theories about addiction i 2382 01:40:42,390 --> 01:40:38,880 personally think i've looked at some 2383 01:40:44,870 --> 01:40:42,400 genetic studies i'm of ashkenazi jewish 2384 01:40:46,470 --> 01:40:44,880 heritage i 2385 01:40:49,109 --> 01:40:46,480 although there's plenty of jews who 2386 01:40:51,510 --> 01:40:49,119 become addicts and alcoholics i have 2387 01:40:53,990 --> 01:40:51,520 seen some studies indicating that my 2388 01:40:56,470 --> 01:40:54,000 particular genetic makeup may be 2389 01:40:59,030 --> 01:40:56,480 slightly more product protective against 2390 01:41:01,590 --> 01:40:59,040 addiction but also i didn't grow up in 2391 01:41:02,870 --> 01:41:01,600 an environment where everybody was doing 2392 01:41:04,950 --> 01:41:02,880 it when i was 2393 01:41:07,510 --> 01:41:04,960 age people were taking 2394 01:41:11,189 --> 01:41:07,520 which i i stopped i started taking 2395 01:41:13,030 --> 01:41:11,199 marijuana at 15 and stopped at 21. i so 2396 01:41:16,070 --> 01:41:13,040 people were taking psychedelics which i 2397 01:41:17,910 --> 01:41:16,080 never took i did some marijuana and i 2398 01:41:20,229 --> 01:41:17,920 stopped because i was getting too 2399 01:41:21,990 --> 01:41:20,239 paranoid in marijuana and i just knew my 2400 01:41:27,350 --> 01:41:22,000 own tolerance 2401 01:41:30,709 --> 01:41:27,360 for it was very low it was very uh 2402 01:41:32,310 --> 01:41:30,719 depressing to me you know that yeah well 2403 01:41:33,669 --> 01:41:32,320 you know don't don't if that's true 2404 01:41:36,310 --> 01:41:33,679 though what you're saying is that 2405 01:41:38,470 --> 01:41:36,320 environment can play a huge part so in 2406 01:41:40,709 --> 01:41:38,480 other words i grew up in a neighborhood 2407 01:41:42,470 --> 01:41:40,719 right next to the heroin capital of the 2408 01:41:46,390 --> 01:41:42,480 east coast of the united states and 2409 01:41:48,709 --> 01:41:46,400 irwin was everywhere and and i i 2410 01:41:51,109 --> 01:41:48,719 remember growing up like to me 2411 01:41:52,709 --> 01:41:51,119 uh i avoided it like the plague because 2412 01:41:54,550 --> 01:41:52,719 i saw the harm that it did to other 2413 01:41:56,149 --> 01:41:54,560 people but some people that i grew up 2414 01:41:57,910 --> 01:41:56,159 with were not that lucky i can't tell 2415 01:42:00,149 --> 01:41:57,920 you how many people i grew up with that 2416 01:42:02,709 --> 01:42:00,159 died of a heroin overdose well because 2417 01:42:04,870 --> 01:42:02,719 it was such it was right there it was 2418 01:42:06,149 --> 01:42:04,880 everywhere where we lived and there was 2419 01:42:08,070 --> 01:42:06,159 people trying to sell it to you 2420 01:42:10,870 --> 01:42:08,080 constantly you know 2421 01:42:12,390 --> 01:42:10,880 so in my case my i came from an earlier 2422 01:42:16,470 --> 01:42:12,400 generation where people were using 2423 01:42:17,990 --> 01:42:16,480 psychedelics that were easily obtained 2424 01:42:20,709 --> 01:42:18,000 and 2425 01:42:23,430 --> 01:42:20,719 also marijuana was very common but the 2426 01:42:26,149 --> 01:42:23,440 dosages of marijuana 2427 01:42:27,430 --> 01:42:26,159 were much much less potent than you get 2428 01:42:30,709 --> 01:42:27,440 today 2429 01:42:33,109 --> 01:42:30,719 and surprisingly i later learned that it 2430 01:42:35,189 --> 01:42:33,119 is possible to become 2431 01:42:37,350 --> 01:42:35,199 ines some you can actually become 2432 01:42:40,070 --> 01:42:37,360 addicted in some ways to marijuana but 2433 01:42:41,830 --> 01:42:40,080 marijuana is way better than 2434 01:42:43,830 --> 01:42:41,840 it's psychologically it's for sure 2435 01:42:45,430 --> 01:42:43,840 psychologically addictive to some people 2436 01:42:47,109 --> 01:42:45,440 yeah they get used to it they want to 2437 01:42:49,030 --> 01:42:47,119 have it every day and then they get a 2438 01:42:51,350 --> 01:42:49,040 little antsy if they don't if they don't 2439 01:42:53,590 --> 01:42:51,360 have any but it's it's nowhere near the 2440 01:42:56,229 --> 01:42:53,600 level but i do think 2441 01:42:58,870 --> 01:42:56,239 i do think that marijuana for adolescent 2442 01:42:59,990 --> 01:42:58,880 brains is kind of real sure yeah you 2443 01:43:02,390 --> 01:43:00,000 know so 2444 01:43:04,070 --> 01:43:02,400 all of these things require some nuance 2445 01:43:05,910 --> 01:43:04,080 and intelligence 2446 01:43:08,629 --> 01:43:05,920 and not every 2447 01:43:11,109 --> 01:43:08,639 not every circumstance for every drug is 2448 01:43:12,310 --> 01:43:11,119 all the same for everybody and that 2449 01:43:17,270 --> 01:43:12,320 seems to be 2450 01:43:20,149 --> 01:43:17,280 is what we have now 2451 01:43:21,669 --> 01:43:20,159 stop opioid medication that's for 2452 01:43:22,790 --> 01:43:21,679 chronic pain 2453 01:43:25,590 --> 01:43:22,800 drugs 2454 01:43:29,030 --> 01:43:25,600 just throw them in jail don't don't 2455 01:43:30,870 --> 01:43:29,040 allow them alternatives and uh and by 2456 01:43:34,070 --> 01:43:30,880 the way uh we're gonna 2457 01:43:36,629 --> 01:43:34,080 yeah it's just so many and then and then 2458 01:43:39,669 --> 01:43:36,639 and then just keep up and then that's 2459 01:43:43,109 --> 01:43:39,679 the horrifying element of the 2460 01:43:46,229 --> 01:43:43,119 treatment universe like i look closely 2461 01:43:47,990 --> 01:43:46,239 at bad drug treatment programs and tough 2462 01:43:51,109 --> 01:43:48,000 love programs 2463 01:43:54,870 --> 01:43:51,119 and i was following again the earlier 2464 01:43:57,350 --> 01:43:54,880 work of maya but i did i did a story 2465 01:43:59,910 --> 01:43:57,360 uh about this for newsweek that was 2466 01:44:02,870 --> 01:43:59,920 about this fundamentalist christian 2467 01:44:04,709 --> 01:44:02,880 tough love school that took kids from 2468 01:44:07,189 --> 01:44:04,719 around the country whose parents were 2469 01:44:09,669 --> 01:44:07,199 christian believers and they were either 2470 01:44:11,750 --> 01:44:09,679 misbehaving having premarital sex or 2471 01:44:14,470 --> 01:44:11,760 using drugs and they sent into this 2472 01:44:16,790 --> 01:44:14,480 basically fundamentalist torture program 2473 01:44:19,669 --> 01:44:16,800 that existed for like five or six years 2474 01:44:21,910 --> 01:44:19,679 where kids were hung up down in shackles 2475 01:44:25,030 --> 01:44:21,920 and beaten with 2476 01:44:27,270 --> 01:44:25,040 whips and and leather belts and forced 2477 01:44:30,629 --> 01:44:27,280 into fighting matches it went on for 2478 01:44:33,350 --> 01:44:30,639 five years with the complete protection 2479 01:44:34,790 --> 01:44:33,360 of the attorney general and local law 2480 01:44:35,990 --> 01:44:34,800 enforcement 2481 01:44:37,990 --> 01:44:36,000 because 2482 01:44:39,990 --> 01:44:38,000 they were fundamentalists and nobody 2483 01:44:42,709 --> 01:44:40,000 wanted to go after the churches but i 2484 01:44:44,950 --> 01:44:42,719 also did an earlier piece that since 2485 01:44:47,109 --> 01:44:44,960 been expanded where i looked at a 2486 01:44:49,430 --> 01:44:47,119 company called crc health which is the 2487 01:44:51,910 --> 01:44:49,440 largest methadone provider but they also 2488 01:44:55,189 --> 01:44:51,920 had a lot of drug treatment programs 2489 01:44:58,229 --> 01:44:55,199 that were had a horrible record for 2490 01:45:01,350 --> 01:44:58,239 maltreatment and deaths including one of 2491 01:45:03,590 --> 01:45:01,360 their name brand programs with and i'm 2492 01:45:06,310 --> 01:45:03,600 gonna add the caveat some of this is 2493 01:45:07,990 --> 01:45:06,320 alleged because they never went let's be 2494 01:45:09,990 --> 01:45:08,000 careful 2495 01:45:12,470 --> 01:45:10,000 some of this is alleged and in 2496 01:45:15,109 --> 01:45:12,480 settlements that they made they never 2497 01:45:16,470 --> 01:45:15,119 admit wrongdoing but but there was a 2498 01:45:19,189 --> 01:45:16,480 particular 2499 01:45:22,390 --> 01:45:19,199 top of the line program called sierra 2500 01:45:24,629 --> 01:45:22,400 tucson where rush limbo and ringo store 2501 01:45:28,229 --> 01:45:24,639 went for drug treatment so you'd think 2502 01:45:31,350 --> 01:45:28,239 oh this is the top line but it was so 2503 01:45:32,629 --> 01:45:31,360 when when an equity firm called 2504 01:45:33,669 --> 01:45:32,639 um 2505 01:45:36,330 --> 01:45:33,679 uh 2506 01:45:40,790 --> 01:45:37,910 [Music] 2507 01:45:42,229 --> 01:45:40,800 it's romney's uh equity firm his name is 2508 01:45:43,109 --> 01:45:42,239 flipping my money 2509 01:45:45,590 --> 01:45:43,119 uh 2510 01:45:47,270 --> 01:45:45,600 bang capital took it over so all they 2511 01:45:49,590 --> 01:45:47,280 cared about was squeezing right 2512 01:45:53,109 --> 01:45:49,600 squeezing bucks out of it yeah right and 2513 01:45:55,109 --> 01:45:53,119 so so i did a piece for salon and other 2514 01:45:57,270 --> 01:45:55,119 and then it's also in my book so they 2515 01:46:00,310 --> 01:45:57,280 took it over and they began slashing the 2516 01:46:02,709 --> 01:46:00,320 staff and basically you know just bring 2517 01:46:04,470 --> 01:46:02,719 people in they didn't vet people for 2518 01:46:06,790 --> 01:46:04,480 whether they had pre-existing mental 2519 01:46:07,830 --> 01:46:06,800 health or suicide issues so they had 2520 01:46:10,390 --> 01:46:07,840 about 2521 01:46:12,390 --> 01:46:10,400 five to ten deaths in the space of a few 2522 01:46:15,430 --> 01:46:12,400 years at sierra tucson 2523 01:46:18,870 --> 01:46:15,440 and in one case they had a a very 2524 01:46:22,629 --> 01:46:18,880 suicidal md who had addiction problems 2525 01:46:26,149 --> 01:46:22,639 he killed himself while at the facility 2526 01:46:28,310 --> 01:46:26,159 and his body was not found on their own 2527 01:46:29,430 --> 01:46:28,320 grounds for two weeks 2528 01:46:32,310 --> 01:46:29,440 geez 2529 01:46:34,390 --> 01:46:32,320 okay that's terrible right so 2530 01:46:36,070 --> 01:46:34,400 so yeah so this is this is actually the 2531 01:46:37,430 --> 01:46:36,080 one of the things on my list i wanted to 2532 01:46:38,229 --> 01:46:37,440 talk about the 2533 01:46:40,149 --> 01:46:38,239 the 2534 01:46:41,910 --> 01:46:40,159 if you could give us some insight into 2535 01:46:44,390 --> 01:46:41,920 the treatment industry and some of the 2536 01:46:45,910 --> 01:46:44,400 corruption in it and so this is right 2537 01:46:48,709 --> 01:46:45,920 right in line with that 2538 01:46:50,070 --> 01:46:48,719 yeah well it's corrupt on so many ways 2539 01:46:51,430 --> 01:46:50,080 because there's no meaningful 2540 01:46:54,870 --> 01:46:51,440 accountability 2541 01:46:55,830 --> 01:46:54,880 so beyond them not offering what works 2542 01:46:59,830 --> 01:46:55,840 okay 2543 01:47:02,390 --> 01:46:59,840 beyond that the other thing is it is 2544 01:47:04,470 --> 01:47:02,400 basically a racket so there's a lot of 2545 01:47:06,950 --> 01:47:04,480 like kickbacks 2546 01:47:09,270 --> 01:47:06,960 to doctors some of which gets exposed 2547 01:47:10,950 --> 01:47:09,280 where they're recommended to go to 2548 01:47:13,910 --> 01:47:10,960 treatment facilities either for 2549 01:47:15,189 --> 01:47:13,920 addiction or tough love programs 2550 01:47:17,590 --> 01:47:15,199 and 2551 01:47:21,430 --> 01:47:17,600 it's basically an unaccountable industry 2552 01:47:24,550 --> 01:47:21,440 that's had an extremely large share of 2553 01:47:26,470 --> 01:47:24,560 needless deaths and suicides after 2554 01:47:27,750 --> 01:47:26,480 people go through 2555 01:47:29,830 --> 01:47:27,760 and then 2556 01:47:32,950 --> 01:47:29,840 even dr um 2557 01:47:34,870 --> 01:47:32,960 uh dr drew for instance was a celebrity 2558 01:47:37,910 --> 01:47:34,880 you know rehab oh yeah he was pumping 2559 01:47:40,709 --> 01:47:37,920 these things yeah and dr phil too dr 2560 01:47:44,149 --> 01:47:40,719 phil was pumping here's the thing about 2561 01:47:47,590 --> 01:47:44,159 dr drew dr drew singh according to some 2562 01:47:49,669 --> 01:47:47,600 reporting about 13 percent of the people 2563 01:47:50,790 --> 01:47:49,679 who went through his program as of a few 2564 01:47:52,790 --> 01:47:50,800 years ago 2565 01:47:54,470 --> 01:47:52,800 died okay 2566 01:47:55,669 --> 01:47:54,480 so you're pretty high percentage yeah 2567 01:47:57,270 --> 01:47:55,679 you've got a 13 2568 01:47:59,750 --> 01:47:57,280 chance of dying if you go to his 2569 01:48:01,270 --> 01:47:59,760 treatment program i'd stay clear doing 2570 01:48:03,109 --> 01:48:01,280 you know this is according to some 2571 01:48:05,830 --> 01:48:03,119 reporting that's been done 2572 01:48:07,990 --> 01:48:05,840 and so they're not held accountable for 2573 01:48:09,830 --> 01:48:08,000 meaningful outcomes but one of the 2574 01:48:11,350 --> 01:48:09,840 things that is 2575 01:48:14,149 --> 01:48:11,360 that's where this issue of dual 2576 01:48:17,270 --> 01:48:14,159 diagnosis and i really drilled into that 2577 01:48:23,430 --> 01:48:20,149 there's a doctor uh uh mark mcgovern of 2578 01:48:25,910 --> 01:48:23,440 stanford and others who have looked at 2579 01:48:28,709 --> 01:48:25,920 this issue where about half the people 2580 01:48:31,109 --> 01:48:28,719 with and this is important for these 2581 01:48:31,990 --> 01:48:31,119 facilities about half the people 2582 01:48:34,229 --> 01:48:32,000 with 2583 01:48:37,669 --> 01:48:34,239 substance abuse have some kind of 2584 01:48:40,950 --> 01:48:37,679 important mental illness issue that's 2585 01:48:45,350 --> 01:48:40,960 debilitating and problematic and then 2586 01:48:46,870 --> 01:48:45,360 similarly uh about half of people who 2587 01:48:49,590 --> 01:48:46,880 have um 2588 01:48:51,910 --> 01:48:49,600 you know are mentally ill and severely 2589 01:48:54,390 --> 01:48:51,920 mentally ill also have substance abuse 2590 01:48:57,109 --> 01:48:54,400 and that accounts for some of the 2591 01:48:59,430 --> 01:48:57,119 populations in addition to the housing 2592 01:49:01,430 --> 01:48:59,440 shortage and our economic collapse in 2593 01:49:03,590 --> 01:49:01,440 the homeless population but these 2594 01:49:07,030 --> 01:49:03,600 facilities so there was this guy he 2595 01:49:10,390 --> 01:49:07,040 would develop this phenomenal program 2596 01:49:13,990 --> 01:49:10,400 uh where it was in use in connecticut 2597 01:49:15,430 --> 01:49:14,000 where he measured the in he could take a 2598 01:49:20,709 --> 01:49:15,440 half day 2599 01:49:23,030 --> 01:49:20,719 program and determine are they using 2600 01:49:25,030 --> 01:49:23,040 evidence-based practices what kind of 2601 01:49:27,990 --> 01:49:25,040 outcomes are they getting and it was a 2602 01:49:31,510 --> 01:49:28,000 kind of a rating yardstick 2603 01:49:32,950 --> 01:49:31,520 and for evaluating the dual diagnosis 2604 01:49:35,510 --> 01:49:32,960 treatments of both drug clinics and 2605 01:49:36,870 --> 01:49:35,520 mental health so here's what he found 2606 01:49:37,990 --> 01:49:36,880 he found 2607 01:49:41,510 --> 01:49:38,000 that 2608 01:49:42,390 --> 01:49:41,520 drug only uh 80 percent 2609 01:49:43,990 --> 01:49:42,400 of 2610 01:49:47,189 --> 01:49:44,000 drug clinics 2611 01:49:50,470 --> 01:49:47,199 that he was invited into study 2612 01:49:53,589 --> 01:49:50,480 and that proudly advertised that they 2613 01:49:56,310 --> 01:49:53,599 were offering dual diagnosis 2614 01:50:00,950 --> 01:49:56,320 didn't meet even the barest minimum 2615 01:50:03,750 --> 01:50:02,790 then when it came to mental health 2616 01:50:07,109 --> 01:50:03,760 treatment 2617 01:50:09,109 --> 01:50:07,119 only 10 percent met that met these 2618 01:50:11,030 --> 01:50:09,119 standards now here's why this is 2619 01:50:13,350 --> 01:50:11,040 especially important 2620 01:50:15,669 --> 01:50:13,360 the surgeon general came out under the 2621 01:50:17,990 --> 01:50:15,679 obama administration with a very very 2622 01:50:20,709 --> 01:50:18,000 good report about addiction 2623 01:50:23,350 --> 01:50:20,719 uh addiction issues and substance abuse 2624 01:50:25,990 --> 01:50:23,360 so her report found 2625 01:50:27,830 --> 01:50:26,000 that for the entire universe of people 2626 01:50:30,790 --> 01:50:27,840 with substance abuse 2627 01:50:31,990 --> 01:50:30,800 only about 10 percent of them 2628 01:50:33,910 --> 01:50:32,000 got 2629 01:50:36,310 --> 01:50:33,920 specialized treatment of any kind 2630 01:50:37,669 --> 01:50:36,320 whether it was good or bad so if you 2631 01:50:40,629 --> 01:50:37,679 take 2632 01:50:43,030 --> 01:50:40,639 this research from stanford 2633 01:50:45,030 --> 01:50:43,040 and you apply it to 10 2634 01:50:45,830 --> 01:50:45,040 so that means 2635 01:50:47,350 --> 01:50:45,840 if 2636 01:50:51,430 --> 01:50:47,360 let's say 2637 01:50:53,990 --> 01:50:51,440 at worst uh 10 only 10 percent of drug 2638 01:50:57,350 --> 01:50:54,000 treatment of at you know between 10 and 2639 01:50:59,589 --> 01:50:57,360 20 percent are offering effective care 2640 01:51:03,830 --> 01:50:59,599 that means out of 100 people with 2641 01:51:07,830 --> 01:51:03,840 substance abuse only one or two 2642 01:51:10,390 --> 01:51:07,840 are getting effective care and 98 2643 01:51:12,390 --> 01:51:10,400 goodbye and good luck like from the 2000 2644 01:51:15,109 --> 01:51:12,400 year old man they're not getting 2645 01:51:17,270 --> 01:51:15,119 anything of competent care 2646 01:51:20,470 --> 01:51:17,280 so how can you have any meaningful 2647 01:51:23,669 --> 01:51:20,480 recovery if 98 2648 01:51:26,390 --> 01:51:23,679 of people are not getting competent care 2649 01:51:28,070 --> 01:51:26,400 and that's similar to the suboxone 2650 01:51:30,229 --> 01:51:28,080 debacle where 2651 01:51:33,589 --> 01:51:30,239 90 percent of people's substance abuse 2652 01:51:35,830 --> 01:51:33,599 do have no access to suboxone and 2653 01:51:38,310 --> 01:51:35,840 another weirdo development that is 2654 01:51:40,390 --> 01:51:38,320 happening right now is even though 2655 01:51:43,350 --> 01:51:40,400 people with substance abuse who could 2656 01:51:46,229 --> 01:51:43,360 benefit from it chronic pain patients 2657 01:51:49,589 --> 01:51:46,239 are bizarrely being forced to admit 2658 01:51:51,910 --> 01:51:49,599 their addicts quote and they're being if 2659 01:51:54,709 --> 01:51:51,920 they want any quote opioids you're being 2660 01:51:57,589 --> 01:51:54,719 given suboxone even though it's 2661 01:52:00,390 --> 01:51:57,599 its ability to prevent or help on severe 2662 01:52:03,669 --> 01:52:00,400 pain is very limited so what kind of 2663 01:52:07,030 --> 01:52:03,679 crazy topsy forcing down the throat a 2664 01:52:10,390 --> 01:52:07,040 mildly effective if at all pain 2665 01:52:13,990 --> 01:52:10,400 medication that could be used to 2666 01:52:16,629 --> 01:52:14,000 help people with substance abuse not die 2667 01:52:18,470 --> 01:52:16,639 and instead it's being forced down the 2668 01:52:21,189 --> 01:52:18,480 throat of chronic pain patients who 2669 01:52:23,750 --> 01:52:21,199 aren't benefiting from it i i really 2670 01:52:26,709 --> 01:52:23,760 can't figure out that's where 2671 01:52:28,950 --> 01:52:26,719 maybe this was designed by aliens steve 2672 01:52:30,550 --> 01:52:28,960 maybe yeah well this system 2673 01:52:32,390 --> 01:52:30,560 this this whole 2674 01:52:35,750 --> 01:52:32,400 you know it's shocking 2675 01:52:38,629 --> 01:52:35,760 the the level of of failure in this 2676 01:52:40,950 --> 01:52:38,639 system because it's not one entity that 2677 01:52:43,669 --> 01:52:40,960 failed it seems like all of them failed 2678 01:52:46,629 --> 01:52:43,679 here right but there's these role models 2679 01:52:47,669 --> 01:52:46,639 of effect of care so like if i was a 2680 01:52:50,950 --> 01:52:47,679 veteran 2681 01:52:53,430 --> 01:52:50,960 and i lived now in birmingham and i went 2682 01:52:57,030 --> 01:52:53,440 to where stevonn cortez 2683 01:52:59,350 --> 01:52:57,040 is a treating physician at the va 2684 01:53:01,109 --> 01:52:59,360 and i was having pain issues 2685 01:53:03,589 --> 01:53:01,119 and addiction issues because he's also 2686 01:53:06,709 --> 01:53:03,599 an addiction specialist boy i'd be lucky 2687 01:53:11,350 --> 01:53:06,719 to see him there's also about you know 2688 01:53:12,550 --> 01:53:11,360 there is a growing awareness of of um 2689 01:53:15,430 --> 01:53:12,560 of you know 2690 01:53:17,990 --> 01:53:15,440 harm reduction movements there there's 2691 01:53:21,350 --> 01:53:18,000 an awareness of the value of suboxone 2692 01:53:24,149 --> 01:53:21,360 now when it comes to aa and n a they can 2693 01:53:25,990 --> 01:53:24,159 definitely be life-changing but there's 2694 01:53:28,629 --> 01:53:26,000 an anti-medication 2695 01:53:30,550 --> 01:53:28,639 treatment attitude in those 2696 01:53:33,669 --> 01:53:30,560 groups that if you somehow take a 2697 01:53:36,229 --> 01:53:33,679 medication ferment now this varies but 2698 01:53:39,510 --> 01:53:36,239 it used to be almost uniform that if you 2699 01:53:41,750 --> 01:53:39,520 took a medication for mental illness 2700 01:53:44,629 --> 01:53:41,760 and then subsequently either for mental 2701 01:53:47,510 --> 01:53:44,639 illness you were kind of frowned on in 2702 01:53:50,310 --> 01:53:47,520 any area i've heard that yeah yeah and 2703 01:53:53,189 --> 01:53:50,320 and and and if that attitude which has 2704 01:53:55,430 --> 01:53:53,199 been extended like oh you're not really 2705 01:53:56,550 --> 01:53:55,440 becoming sober 2706 01:53:59,030 --> 01:53:56,560 you're not because you're on this 2707 01:54:01,750 --> 01:53:59,040 medication if you're on medication and 2708 01:54:04,550 --> 01:54:01,760 if you're on suboxone or methadone well 2709 01:54:06,629 --> 01:54:04,560 you're not really following the 12 steps 2710 01:54:09,350 --> 01:54:06,639 now the 12 steps 2711 01:54:11,910 --> 01:54:09,360 can be really valuable and life-changing 2712 01:54:14,390 --> 01:54:11,920 but it's but it certainly should not be 2713 01:54:15,589 --> 01:54:14,400 something that you can you know gets 2714 01:54:18,790 --> 01:54:15,599 paid for 2715 01:54:22,470 --> 01:54:18,800 by the government as the primary form of 2716 01:54:24,310 --> 01:54:22,480 treatment in two-thirds of all of the 2717 01:54:26,229 --> 01:54:24,320 country's treatment facilities that's 2718 01:54:28,070 --> 01:54:26,239 just nuts 2719 01:54:30,070 --> 01:54:28,080 yeah and there's also a lot of there's 2720 01:54:31,750 --> 01:54:30,080 also a lot of treatment stuff out there 2721 01:54:33,910 --> 01:54:31,760 that's a little bit wacky like 2722 01:54:34,709 --> 01:54:33,920 scientology has its narconon program 2723 01:54:36,950 --> 01:54:34,719 right 2724 01:54:38,390 --> 01:54:36,960 where they put you in a sauna and give 2725 01:54:40,550 --> 01:54:38,400 you a whole bunch of vitamins and they 2726 01:54:43,350 --> 01:54:40,560 call that drug treatment i just don't 2727 01:54:44,629 --> 01:54:43,360 understand anybody you know i mean some 2728 01:54:47,149 --> 01:54:44,639 people fall into it they don't know 2729 01:54:50,390 --> 01:54:47,159 that's what they're gonna get they 2730 01:54:53,350 --> 01:54:50,400 think vitamins the 2731 01:54:56,229 --> 01:54:53,360 group doesn't advertise hello we are a 2732 01:54:59,589 --> 01:54:56,239 branch of weirdo scientology they're 2733 01:55:01,669 --> 01:54:59,599 kind of they don't openly i'm sure a lot 2734 01:55:04,550 --> 01:55:01,679 of people know that but 2735 01:55:05,910 --> 01:55:04,560 yes so the point is that there's 2736 01:55:08,390 --> 01:55:05,920 nobody's held 2737 01:55:11,510 --> 01:55:08,400 there's no rigorous objective standards 2738 01:55:13,910 --> 01:55:11,520 for outcomes and that's where mcgovern's 2739 01:55:15,910 --> 01:55:13,920 uh plan when used in connecticut so we 2740 01:55:19,030 --> 01:55:15,920 have this yardstick for measuring 2741 01:55:21,990 --> 01:55:19,040 something very clear how good 2742 01:55:23,910 --> 01:55:22,000 were they at dual diagnosis treatment 2743 01:55:27,430 --> 01:55:23,920 and he did it for both outpatient 2744 01:55:29,990 --> 01:55:27,440 inpatient facilities and the upshot was 2745 01:55:31,510 --> 01:55:30,000 by having this government measured 2746 01:55:35,990 --> 01:55:31,520 yardstick 2747 01:55:38,310 --> 01:55:36,000 they then were pressed on improving 2748 01:55:41,030 --> 01:55:38,320 and they wouldn't get state funds unless 2749 01:55:43,189 --> 01:55:41,040 they improved it was a it was a weapon 2750 01:55:45,830 --> 01:55:43,199 and an assessment tool and then guess 2751 01:55:47,430 --> 01:55:45,840 what happened this was being promoted in 2752 01:55:49,990 --> 01:55:47,440 30 states 2753 01:55:51,189 --> 01:55:50,000 by uh the substance abuse and mental 2754 01:55:54,070 --> 01:55:51,199 health 2755 01:55:56,629 --> 01:55:54,080 uh services so you know the samsha the 2756 01:55:58,709 --> 01:55:56,639 leading kind of mental health and drug 2757 01:56:01,430 --> 01:55:58,719 you know practice government it was 2758 01:56:03,750 --> 01:56:01,440 promoted and then in 2012 2759 01:56:06,870 --> 01:56:03,760 just as the opioid 2760 01:56:10,149 --> 01:56:06,880 epidemic was skyrocketing and going 2761 01:56:12,950 --> 01:56:10,159 crazy they yanked this tool 2762 01:56:15,510 --> 01:56:12,960 and so the number of states once 30 are 2763 01:56:16,629 --> 01:56:15,520 down to practically nothing and this 2764 01:56:18,790 --> 01:56:16,639 doctor 2765 01:56:20,950 --> 01:56:18,800 who knows in his head where effective 2766 01:56:23,030 --> 01:56:20,960 care is so they used to even have a 2767 01:56:25,030 --> 01:56:23,040 website where you could look up who 2768 01:56:28,870 --> 01:56:25,040 meets these good standards you could go 2769 01:56:31,189 --> 01:56:28,880 there that website doesn't exist anymore 2770 01:56:32,629 --> 01:56:31,199 because nobody bothered to review the 2771 01:56:36,070 --> 01:56:32,639 domain name 2772 01:56:38,470 --> 01:56:36,080 and it's not there so it turns out the 2773 01:56:41,510 --> 01:56:38,480 knowledge of where the really great 2774 01:56:44,470 --> 01:56:41,520 treatment programs is in this guy's head 2775 01:56:47,109 --> 01:56:44,480 and fellow researchers and doctors call 2776 01:56:49,990 --> 01:56:47,119 him up when their family members are in 2777 01:56:52,470 --> 01:56:50,000 crisis over opioids what do we do where 2778 01:56:55,350 --> 01:56:52,480 do we go and he tells them but it 2779 01:56:56,709 --> 01:56:55,360 shouldn't be up to one doctor's informal 2780 01:57:00,149 --> 01:56:56,719 knowledge 2781 01:57:01,910 --> 01:57:00,159 and and that's where we are 2782 01:57:03,109 --> 01:57:01,920 we have a good comment here from uh 2783 01:57:05,910 --> 01:57:03,119 stefan 2784 01:57:07,750 --> 01:57:05,920 cortez uh saying no one forced medical 2785 01:57:10,070 --> 01:57:07,760 schools to hold back from training in 2786 01:57:12,390 --> 01:57:10,080 pain and addiction we the medical 2787 01:57:14,070 --> 01:57:12,400 profession did that all by ourselves you 2788 01:57:15,510 --> 01:57:14,080 think there should be some reforms in 2789 01:57:17,109 --> 01:57:15,520 medical schools 2790 01:57:19,750 --> 01:57:17,119 and and further 2791 01:57:21,990 --> 01:57:19,760 you know yeah to instruct 2792 01:57:24,550 --> 01:57:22,000 doctors to be how to handle these yes 2793 01:57:28,149 --> 01:57:24,560 right i think that should be the problem 2794 01:57:30,709 --> 01:57:28,159 with uh doctors and there's a 2795 01:57:32,470 --> 01:57:30,719 doctors are very slow to change unless 2796 01:57:34,390 --> 01:57:32,480 they're forced to 2797 01:57:36,790 --> 01:57:34,400 so they change here's what happened 2798 01:57:40,149 --> 01:57:36,800 obviously they were over lots of diet 2799 01:57:41,030 --> 01:57:40,159 you can force change by sanctions and 2800 01:57:43,589 --> 01:57:41,040 money 2801 01:57:44,470 --> 01:57:43,599 you gotta if it's if you do one of the 2802 01:57:46,149 --> 01:57:44,480 two 2803 01:57:48,629 --> 01:57:46,159 sanctions if you don't do the right 2804 01:57:51,430 --> 01:57:48,639 thing and money if you do the good thing 2805 01:57:53,270 --> 01:57:51,440 if you have those tools people will 2806 01:57:55,589 --> 01:57:53,280 change even if their beliefs are 2807 01:57:57,990 --> 01:57:55,599 different but right now 2808 01:58:00,350 --> 01:57:58,000 part of the culture of medicine is 2809 01:58:04,149 --> 01:58:00,360 something that a social a brilliant 2810 01:58:06,149 --> 01:58:04,159 sociologist named elliot friedson 2811 01:58:07,109 --> 01:58:06,159 called professional dominance which 2812 01:58:09,430 --> 01:58:07,119 means 2813 01:58:11,990 --> 01:58:09,440 doctors are the gods 2814 01:58:13,750 --> 01:58:12,000 and doctors don't like anybody telling 2815 01:58:14,629 --> 01:58:13,760 them what to do 2816 01:58:16,790 --> 01:58:14,639 you know 2817 01:58:19,350 --> 01:58:16,800 and and that and that they kind of rule 2818 01:58:22,870 --> 01:58:19,360 the roost and there's a culture i'm the 2819 01:58:26,629 --> 01:58:22,880 doctor who are you to tell me what to do 2820 01:58:29,189 --> 01:58:26,639 and and that attitude basically 2821 01:58:31,750 --> 01:58:29,199 is you know helps infect medical 2822 01:58:34,390 --> 01:58:31,760 education we have great performers like 2823 01:58:35,910 --> 01:58:34,400 dr cortez who want to change but change 2824 01:58:38,229 --> 01:58:35,920 can happen let me give you a specific 2825 01:58:41,030 --> 01:58:38,239 example it's not an opioids but when 2826 01:58:43,830 --> 01:58:41,040 things are so bad changes can happen so 2827 01:58:46,390 --> 01:58:43,840 it used to be in new york state medical 2828 01:58:49,189 --> 01:58:46,400 schools interns and residents had to 2829 01:58:51,109 --> 01:58:49,199 work 48 hours straight 2830 01:58:53,270 --> 01:58:51,119 okay as part of their toughening up 2831 01:58:54,109 --> 01:58:53,280 process so what was happening when you 2832 01:58:57,830 --> 01:58:54,119 had 2833 01:58:59,910 --> 01:58:57,840 bleary-eyed sometimes speed fueled 2834 01:59:02,390 --> 01:58:59,920 interns and residents and hospitals well 2835 01:59:03,910 --> 01:59:02,400 they made loads of medical mistakes 2836 01:59:05,830 --> 01:59:03,920 and then when the new york times did a 2837 01:59:09,350 --> 01:59:05,840 series about look at all the people who 2838 01:59:12,149 --> 01:59:09,360 died or were paralyzed or harmed because 2839 01:59:14,950 --> 01:59:12,159 of these sleep deprived students 2840 01:59:17,510 --> 01:59:14,960 then the state changed the law 2841 01:59:20,149 --> 01:59:17,520 to make it hey you can't force these 2842 01:59:22,629 --> 01:59:20,159 people to be up 40 hours straight they 2843 01:59:24,629 --> 01:59:22,639 have to have some break but it was only 2844 01:59:25,830 --> 01:59:24,639 because of outside 2845 01:59:30,310 --> 01:59:25,840 pressure 2846 01:59:32,470 --> 01:59:30,320 that's meaningful 2847 01:59:36,149 --> 01:59:32,480 on medical schools 2848 01:59:38,790 --> 01:59:36,159 and and others we're not going to 2849 01:59:41,109 --> 01:59:38,800 see change and that's that's one of the 2850 01:59:44,470 --> 01:59:41,119 disturbing elements for why there's not 2851 01:59:47,750 --> 01:59:44,480 more change is there hasn't been 2852 01:59:48,950 --> 01:59:47,760 effective legal lawsuits against medical 2853 01:59:52,550 --> 01:59:48,960 boards 2854 01:59:55,910 --> 01:59:52,560 or health agencies for kind of 2855 01:59:58,070 --> 01:59:55,920 caught by their failures about not in 2856 02:00:00,149 --> 01:59:58,080 other words they should be held to count 2857 02:00:02,550 --> 02:00:00,159 legally but i don't know the legal 2858 02:00:05,270 --> 02:00:02,560 justification somebody like kate 2859 02:00:08,790 --> 02:00:05,280 nicholson complicated yeah yeah a civil 2860 02:00:12,109 --> 02:00:08,800 disabilities lawyer and others might as 2861 02:00:14,709 --> 02:00:12,119 i mean a disabilities lawyer is these 2862 02:00:17,910 --> 02:00:14,719 institutions that whose 2863 02:00:20,149 --> 02:00:17,920 totally negligent policies are 2864 02:00:22,950 --> 02:00:20,159 driving up suicides 2865 02:00:23,830 --> 02:00:22,960 for chronic pain patients or leading 2866 02:00:27,109 --> 02:00:23,840 people 2867 02:00:29,350 --> 02:00:27,119 into overdose deaths because of their 2868 02:00:31,669 --> 02:00:29,360 failure to use evidence-based care and 2869 02:00:33,189 --> 02:00:31,679 treatment they should be sort of sued 2870 02:00:36,550 --> 02:00:33,199 there should be some kind of class 2871 02:00:38,149 --> 02:00:36,560 action suit that might force them and 2872 02:00:40,390 --> 02:00:38,159 that's one of the problems that's going 2873 02:00:42,310 --> 02:00:40,400 to be happening right now 2874 02:00:43,510 --> 02:00:42,320 there's all this publicity about these 2875 02:00:45,910 --> 02:00:43,520 big 2876 02:00:48,070 --> 02:00:45,920 multi-billion dollar settlements that's 2877 02:00:49,830 --> 02:00:48,080 happening at the federal and state level 2878 02:00:51,830 --> 02:00:49,840 yeah we have somebody in our live chat 2879 02:00:55,030 --> 02:00:51,840 who's who's a member of the class action 2880 02:00:57,109 --> 02:00:55,040 lawsuit against purdue right so that's 2881 02:01:00,629 --> 02:00:57,119 great love to hear their views the 2882 02:01:02,229 --> 02:01:00,639 downside that is worrisome is it's great 2883 02:01:04,709 --> 02:01:02,239 that they're being in theory held 2884 02:01:06,390 --> 02:01:04,719 account but how the money is actually 2885 02:01:09,109 --> 02:01:06,400 going to be used could be really 2886 02:01:12,870 --> 02:01:09,119 problematic it might be just returned to 2887 02:01:15,990 --> 02:01:12,880 the the local stage general fund or even 2888 02:01:18,310 --> 02:01:16,000 if it goes into treatment this is 2889 02:01:21,830 --> 02:01:18,320 horrifying even if it goes into 2890 02:01:25,109 --> 02:01:21,840 treatment it's like an open says me 2891 02:01:27,510 --> 02:01:25,119 huge pocketbook for ineffective care 2892 02:01:28,310 --> 02:01:27,520 they're not going to link the money 2893 02:01:31,830 --> 02:01:28,320 to 2894 02:01:33,510 --> 02:01:31,840 effective modalities of treatment so 2895 02:01:35,589 --> 02:01:33,520 we're going to have this big settlement 2896 02:01:39,030 --> 02:01:35,599 and people go boy we really got the 2897 02:01:41,030 --> 02:01:39,040 opioid manufacturers on the ropes life 2898 02:01:42,229 --> 02:01:41,040 is going to get better it ain't going to 2899 02:01:43,910 --> 02:01:42,239 get better 2900 02:01:45,589 --> 02:01:43,920 no they'll pay out a small portion of 2901 02:01:47,030 --> 02:01:45,599 their profits in a settlement and roll 2902 02:01:48,070 --> 02:01:47,040 along with their business that's what i 2903 02:01:50,470 --> 02:01:48,080 require 2904 02:01:53,589 --> 02:01:50,480 and the treatment facilities that may be 2905 02:01:55,669 --> 02:01:53,599 awash in money new money aren't going to 2906 02:01:56,709 --> 02:01:55,679 be held accountable for how they're 2907 02:02:00,950 --> 02:01:56,719 being 2908 02:02:06,390 --> 02:02:00,960 really 2909 02:02:08,149 --> 02:02:06,400 that's where i in our resource guide 2910 02:02:10,390 --> 02:02:08,159 we're going to be giving you the top 2911 02:02:13,589 --> 02:02:10,400 advocates and reformers experts 2912 02:02:15,910 --> 02:02:13,599 researchers books to pay attention to 2913 02:02:18,470 --> 02:02:15,920 uh so you can learn more and keep you 2914 02:02:20,229 --> 02:02:18,480 and your family safe 2915 02:02:23,109 --> 02:02:20,239 great well you know i notice we're 2916 02:02:25,189 --> 02:02:23,119 already over time uh and i can continue 2917 02:02:26,550 --> 02:02:25,199 talking to you about this all night i 2918 02:02:28,950 --> 02:02:26,560 want to thank you 2919 02:02:31,189 --> 02:02:28,960 uh for for doing this and because i 2920 02:02:34,149 --> 02:02:31,199 consider it a public service you know to 2921 02:02:36,310 --> 02:02:34,159 try to raise awareness of these issues 2922 02:02:38,950 --> 02:02:36,320 and and the problems that we're facing 2923 02:02:41,109 --> 02:02:38,960 and maybe offer some possible solutions 2924 02:02:42,950 --> 02:02:41,119 and i know that you have a tremendous 2925 02:02:44,149 --> 02:02:42,960 interest and passion towards helping 2926 02:02:46,790 --> 02:02:44,159 these people 2927 02:02:48,310 --> 02:02:46,800 uh that have been affected by the opioid 2928 02:02:50,870 --> 02:02:48,320 epidemic 2929 02:02:53,430 --> 02:02:50,880 um and and hopefully you will agree to 2930 02:02:56,310 --> 02:02:53,440 come back uh again and maybe we can 2931 02:02:58,070 --> 02:02:56,320 another also had mentioned uh that you 2932 02:03:00,629 --> 02:02:58,080 this would be the first of a series you 2933 02:03:03,189 --> 02:03:00,639 may be having people with 2934 02:03:05,430 --> 02:03:03,199 experience with these issues and people 2935 02:03:06,870 --> 02:03:05,440 on the ground clinicians 2936 02:03:08,870 --> 02:03:06,880 yes i'm going to be doing several 2937 02:03:11,990 --> 02:03:08,880 interviews on this issue with different 2938 02:03:12,709 --> 02:03:12,000 people um i've got a i've got a somebody 2939 02:03:18,070 --> 02:03:12,719 who 2940 02:03:19,750 --> 02:03:18,080 in outreach for for victims of opioid 2941 02:03:21,910 --> 02:03:19,760 addiction and trying to help them and 2942 02:03:23,830 --> 02:03:21,920 get them in the treatment programs i've 2943 02:03:25,350 --> 02:03:23,840 also got several people who are just 2944 02:03:27,030 --> 02:03:25,360 opioid addicts 2945 02:03:29,189 --> 02:03:27,040 right that i'm going to interview so 2946 02:03:31,589 --> 02:03:29,199 that we can you know personalize it and 2947 02:03:33,830 --> 02:03:31,599 hear personal stories of their struggles 2948 02:03:35,350 --> 02:03:33,840 and how they were able to overcome 2949 02:03:36,870 --> 02:03:35,360 their struggles because i think that 2950 02:03:38,950 --> 02:03:36,880 would be important for people still 2951 02:03:40,709 --> 02:03:38,960 struggling to hear how others were 2952 02:03:43,510 --> 02:03:40,719 successful 2953 02:03:45,830 --> 02:03:43,520 in ridding themselves of the scourge of 2954 02:03:47,510 --> 02:03:45,840 this there's been a network i learned 2955 02:03:49,669 --> 02:03:47,520 about in addition the harm reduction 2956 02:03:51,109 --> 02:03:49,679 coalition and i'll have it's called like 2957 02:03:53,589 --> 02:03:51,119 the urban 2958 02:03:55,589 --> 02:03:53,599 urban survivors organization people who 2959 02:03:57,990 --> 02:03:55,599 are currently 2960 02:03:59,589 --> 02:03:58,000 struggling with addiction and it's a way 2961 02:04:01,430 --> 02:03:59,599 to network with others who are 2962 02:04:04,709 --> 02:04:01,440 struggling with addiction and want to 2963 02:04:08,470 --> 02:04:04,719 see harm reduction both for in their own 2964 02:04:09,430 --> 02:04:08,480 lives and to promote it outward and also 2965 02:04:10,390 --> 02:04:09,440 get 2966 02:04:13,109 --> 02:04:10,400 links to 2967 02:04:15,589 --> 02:04:13,119 effective resources so that people can 2968 02:04:17,510 --> 02:04:15,599 help each other that's really 2969 02:04:19,189 --> 02:04:17,520 what is really important yeah people 2970 02:04:21,030 --> 02:04:19,199 need to know also that they're not alone 2971 02:04:24,629 --> 02:04:21,040 in this and if you are suffering from 2972 02:04:26,470 --> 02:04:24,639 this there is help available you know 2973 02:04:28,390 --> 02:04:26,480 so we're going to try to provide as much 2974 02:04:30,629 --> 02:04:28,400 resources as we can in the about section 2975 02:04:33,109 --> 02:04:30,639 i'm going to be editing that to get as 2976 02:04:35,030 --> 02:04:33,119 much information in there as we can 2977 02:04:36,629 --> 02:04:35,040 um and again i i can't thank you enough 2978 02:04:39,510 --> 02:04:36,639 for doing this mr levine it was a 2979 02:04:41,030 --> 02:04:39,520 pleasure to have you here 2980 02:04:42,790 --> 02:04:41,040 so i'm going to throw you out of here 2981 02:04:45,030 --> 02:04:42,800 and i'm going to quickly uh read these 2982 02:04:46,950 --> 02:04:45,040 super chats and do a quick uh wrap up 2983 02:04:48,069 --> 02:04:46,960 but don't be a stranger and i hope that 2984 02:04:49,910 --> 02:04:48,079 after i get some of these other 2985 02:04:52,229 --> 02:04:49,920 interviews under my belt you'll be able 2986 02:04:53,750 --> 02:04:52,239 to come back and give us more insight i 2987 02:04:55,510 --> 02:04:53,760 look forward to it 2988 02:04:59,030 --> 02:04:55,520 all right thanks very much for your time 2989 02:05:02,149 --> 02:04:59,040 mr art levine and what a tremendous 2990 02:05:06,069 --> 02:05:02,159 stroke of luck to get uh someone who is 2991 02:05:07,589 --> 02:05:06,079 so well informed so passionate and just 2992 02:05:11,830 --> 02:05:07,599 uh 2993 02:05:13,270 --> 02:05:11,840 issues 2994 02:05:15,750 --> 02:05:13,280 you know i've been wanting to cover this 2995 02:05:17,750 --> 02:05:15,760 for a while for those of you that are 2996 02:05:20,069 --> 02:05:17,760 unaware i grew up right next to some 2997 02:05:22,870 --> 02:05:20,079 place in philadelphia uh called 2998 02:05:23,669 --> 02:05:22,880 kensington and you can look on youtube 2999 02:05:27,030 --> 02:05:23,679 just 3000 02:05:29,109 --> 02:05:27,040 k-e-n-s-i-n-g-t-o and it's a 3001 02:05:31,910 --> 02:05:29,119 neighborhood in philadelphia that has 3002 02:05:33,350 --> 02:05:31,920 been just destroyed and devastated over 3003 02:05:36,390 --> 02:05:33,360 opioids 3004 02:05:38,709 --> 02:05:36,400 and heroin and fentanyl now it is the 3005 02:05:40,870 --> 02:05:38,719 capital of the east coast 3006 02:05:43,270 --> 02:05:40,880 uh for for 3007 02:05:44,950 --> 02:05:43,280 addicts suffering with this form of 3008 02:05:47,270 --> 02:05:44,960 addiction and i have seen the 3009 02:05:50,629 --> 02:05:47,280 devastation firsthand i have had 3010 02:05:51,669 --> 02:05:50,639 multiple friends families neighbors die 3011 02:05:52,790 --> 02:05:51,679 or 3012 02:05:54,550 --> 02:05:52,800 die of 3013 02:05:55,510 --> 02:05:54,560 an overdose or 3014 02:05:57,510 --> 02:05:55,520 just 3015 02:06:00,470 --> 02:05:57,520 watched many many people suffer for 3016 02:06:01,750 --> 02:06:00,480 years or even a decade in a few cases 3017 02:06:04,229 --> 02:06:01,760 you know i've known people that were 3018 02:06:05,430 --> 02:06:04,239 long-term suffering from heroin 3019 02:06:08,629 --> 02:06:05,440 addiction 3020 02:06:10,790 --> 02:06:08,639 and this is an issue that is close to 3021 02:06:12,310 --> 02:06:10,800 close to me because i saw it all around 3022 02:06:14,229 --> 02:06:12,320 me growing up 3023 02:06:16,390 --> 02:06:14,239 as we 3024 02:06:18,390 --> 02:06:16,400 slowly realized that we have a platform 3025 02:06:20,550 --> 02:06:18,400 i feel like it's it's our responsibility 3026 02:06:21,669 --> 02:06:20,560 if you develop a good platform that you 3027 02:06:23,189 --> 02:06:21,679 can 3028 02:06:24,790 --> 02:06:23,199 um 3029 02:06:26,709 --> 02:06:24,800 try to do some good in the world and 3030 02:06:27,910 --> 02:06:26,719 that's what we tried to do tonight i am 3031 02:06:30,069 --> 02:06:27,920 going to 3032 02:06:32,870 --> 02:06:30,079 uh read recognize and thank all the 3033 02:06:34,709 --> 02:06:32,880 super chat donators for tonight i 3034 02:06:36,629 --> 02:06:34,719 apologize for not doing it as the 3035 02:06:38,069 --> 02:06:36,639 interview goes but 3036 02:06:40,950 --> 02:06:38,079 you can imagine that it's a little bit 3037 02:06:42,790 --> 02:06:40,960 distracting to stop every few minutes to 3038 02:06:44,229 --> 02:06:42,800 to read the super chats but we certainly 3039 02:06:45,830 --> 02:06:44,239 want to thank everybody for their 3040 02:06:46,790 --> 02:06:45,840 kindness their generosity and their 3041 02:06:49,270 --> 02:06:46,800 support 3042 02:06:51,750 --> 02:06:49,280 and we will read them now rogue status 3043 02:06:53,750 --> 02:06:51,760 with a kind and generous 10 super chat 3044 02:06:55,109 --> 02:06:53,760 who says this one didn't suck hit home 3045 02:06:56,470 --> 02:06:55,119 man thank you very much for your 3046 02:06:57,510 --> 02:06:56,480 kindness your generosity and your 3047 02:06:58,709 --> 02:06:57,520 support 3048 02:07:00,870 --> 02:06:58,719 marina 3049 02:07:03,109 --> 02:07:00,880 mavrogenius i'm getting better at saying 3050 02:07:05,270 --> 02:07:03,119 it every time i have to marina thank you 3051 02:07:07,030 --> 02:07:05,280 for being here thank you for your 3052 02:07:08,310 --> 02:07:07,040 kindness generosity and continued 3053 02:07:10,870 --> 02:07:08,320 support with kind and generous two 3054 02:07:13,189 --> 02:07:10,880 dollar super chat says i'm addicted to 3055 02:07:15,430 --> 02:07:13,199 this great show and great cause and 3056 02:07:16,870 --> 02:07:15,440 again with kind of generous 99 cents 3057 02:07:18,069 --> 02:07:16,880 super sticker 3058 02:07:20,069 --> 02:07:18,079 purchase 3059 02:07:22,310 --> 02:07:20,079 thank you very much marina and finally 3060 02:07:24,149 --> 02:07:22,320 marina with yet another kind of generous 3061 02:07:26,470 --> 02:07:24,159 five dollar super chat donation says 3062 02:07:27,430 --> 02:07:26,480 this is such an important show thank you 3063 02:07:29,270 --> 02:07:27,440 both 3064 02:07:31,589 --> 02:07:29,280 and we have kelly lee dodge with the 3065 02:07:33,430 --> 02:07:31,599 kind of generous canadian 1399 super 3066 02:07:35,430 --> 02:07:33,440 sticker thank you for your kindness your 3067 02:07:37,669 --> 02:07:35,440 generosity and your support and finally 3068 02:07:40,229 --> 02:07:37,679 kelly lee dodge with a kind and generous 3069 02:07:42,310 --> 02:07:40,239 6.99 3070 02:07:43,189 --> 02:07:42,320 chat says just want to support good 3071 02:07:44,870 --> 02:07:43,199 people 3072 02:07:47,750 --> 02:07:44,880 xo 3073 02:07:48,870 --> 02:07:47,760 very kind and generous of all of you 3074 02:07:51,030 --> 02:07:48,880 thank you for your kindness your 3075 02:07:52,870 --> 02:07:51,040 generosity and your support 3076 02:07:54,149 --> 02:07:52,880 i uh 3077 02:07:55,830 --> 02:07:54,159 would like to tell you that this is a 3078 02:07:57,669 --> 02:07:55,840 viewer supported show and the best way 3079 02:07:59,270 --> 02:07:57,679 to support me one of the best ways is 3080 02:08:01,030 --> 02:07:59,280 that money button down there but failing 3081 02:08:02,470 --> 02:08:01,040 that we have a patreon for as little as 3082 02:08:06,229 --> 02:08:02,480 a dollar a month 3083 02:08:07,830 --> 02:08:06,239 and we also accepts uh paypal donations 3084 02:08:10,709 --> 02:08:07,840 i want to thank that girl jessica for a 3085 02:08:13,189 --> 02:08:10,719 kind and generous uh paypal donation it 3086 02:08:15,030 --> 02:08:13,199 is very much appreciated thank you all 3087 02:08:19,420 --> 02:08:15,040 for your kindness your generosity and 3088 02:08:28,790 --> 02:08:26,709 [Music] 3089 02:08:30,709 --> 02:08:28,800 all right friends uh it's been a long 3090 02:08:32,149 --> 02:08:30,719 week and we have produced more content 3091 02:08:33,990 --> 02:08:32,159 this week than we ever have in the 3092 02:08:35,910 --> 02:08:34,000 history of our show trying some new 3093 02:08:37,669 --> 02:08:35,920 things this week i want to thank all of 3094 02:08:38,390 --> 02:08:37,679 you especially those of you who came 3095 02:08:41,430 --> 02:08:38,400 here 3096 02:08:43,189 --> 02:08:41,440 uh expecting the normal topics that we 3097 02:08:45,430 --> 02:08:43,199 cover i realize that we're branching out 3098 02:08:48,390 --> 02:08:45,440 here but i think it's important to not 3099 02:08:50,550 --> 02:08:48,400 pigeonhole yourself and solely cover one 3100 02:08:52,550 --> 02:08:50,560 topic or another we may be branching out 3101 02:08:55,270 --> 02:08:52,560 into other subjects and this series will 3102 02:08:57,030 --> 02:08:55,280 continue i want to thank uh our guest 3103 02:08:59,669 --> 02:08:57,040 tonight art levine who did an incredible 3104 02:09:01,270 --> 02:08:59,679 job helping us to navigate 3105 02:09:03,350 --> 02:09:01,280 this crisis 3106 02:09:05,750 --> 02:09:03,360 uh my thanks to all who joined us in the 3107 02:09:07,270 --> 02:09:05,760 live chat you always hear me say this i 3108 02:09:08,709 --> 02:09:07,280 can't tell you enough how happy i am 3109 02:09:10,390 --> 02:09:08,719 when there's an audience tonight we had 3110 02:09:13,430 --> 02:09:10,400 a great one thank you for being a part 3111 02:09:15,589 --> 02:09:13,440 of mine so until next time friends 3112 02:09:20,130 --> 02:09:15,599 my name is stephen campion good night 3113 02:10:50,330 --> 02:10:11,140 [Music] 3114 02:11:16,920 --> 02:10:50,340 [Applause]